A nurse is preparing to administer an osmotic diuretic IV to a client with increased intracranial pressure. Which of the following should the nurse identify as the purpose of the medication?

Reduce edema of the brain.

Increase cell size in the brain.

Expand extracellular ﬂuid volume.

Provide ﬂuid hydration.

Answer and Explanation

The Correct Answer is A

Choice A Reason: This is correct because an osmotic diuretic, such as mannitol, works by creating an osmotic gradient that draws ﬂuid from the brain tissue into the blood vessels, thereby reducing cerebral edema and intracranial pressure.

Choice B Reason: This is incorrect because an osmotic diuretic would decrease, not increase, the cell size in the brain by removing ﬂuid from the intracellular space.

Choice C Reason: This is incorrect because an osmotic diuretic would decrease, not expand, the extracellular ﬂuid volume by increasing the urine output and excreting excess ﬂuid from the body.

Choice D Reason: This is incorrect because an osmotic diuretic would not provide ﬂuid hydration, but rather cause ﬂuid loss and dehydration.

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Correct Answer is C

Explanation

Choice A Reason: This choice is incorrect because slowing the rate to 50 mL/hr may not be enough to prevent cerebral edema, which is a common complication of head injury. Cerebral edema is a swelling of the brain tissue due to increased ﬂuid accumulation. It can cause increased intracranial pressure (ICP), which can lead to brain damage or death. Therefore, the nurse should limit the ﬂuid intake of the client with head injury to avoid worsening the condition.

Choice B Reason: This choice is incorrect because increasing the rate to 250 mL/hr may cause ﬂuid overload, which can also increase the ICP and worsen the cerebral edema. Fluid overload is a condition in which the body has too much ﬂuid, which can impair the function of the heart, lungs, and kidneys. Therefore, the nurse should avoid giving too much ﬂuid to the client with head injury.

Choice C Reason: This choice is correct because slowing the rate to 20 mL/hr may help to maintain adequate hydration and electrolyte balance, while preventing ﬂuid overload and cerebral edema. This is a conservative approach that can be used until the client's neurological status and ICP are assessed and monitored.

Choice D Reason: This choice is incorrect because continuing the rate at 125 mL/hr may not be appropriate for the client with head injury, depending on their individual needs and condition. The nurse should adjust the ﬂuid rate according to the client's vital signs, urine output, serum osmolality, and ICP. Therefore, the nurse should not assume that this rate is optimal for the client without further evaluation.

A. Verify the prescribed ventilator settings daily. B. Apply restraints if the client becomes agitated. C. Administer pantoprazole as prescribed. D. Reposition the endotracheal tube to the opposite side of the mouth daily. E. Elevate the head of the bed to at least 30°.

Correct Answer is ["A","C","E"]

Explanation

Choice A Reason: This choice is correct because verifying the prescribed ventilator settings daily is an important intervention to ensure that the client is receiving adequate ventilation and oxygenation. The ventilator settings include parameters such as tidal volume, respiratory rate, fraction of inspired oxygen (FiO2), positive end-expiratory pressure (PEEP), and peak inspiratory pressure (PIP). The nurse should check that the settings match the prescription and report any changes or alarms to the provider.

Choice B Reason: This choice is incorrect because applying restraints if the client becomes agitated is not a recommended intervention to prevent complications. Restraints may cause injury, infection, or psychological distress to the client and increase the risk of ventilator-associated pneumonia (VAP). The nurse should use alternative methods to manage agitation, such as sedation, analgesia, or environmental modification.

Choice C Reason: This choice is correct because administering pantoprazole as prescribed is an important intervention to prevent complications. Pantoprazole is a proton pump inhibitor (PPI) that reduces the production of stomach acid and prevents gastroesophageal reﬂux disease (GERD) and stress ulcers. These conditions can cause aspiration, bleeding, or infection in clients who are receiving mechanical ventilation.

Choice D Reason: This choice is incorrect because repositioning the endotracheal tube to the opposite side of the mouth daily is not a recommended intervention to prevent complications. Repositioning the endotracheal tube may cause trauma, bleeding, or displacement of the tube, which can compromise the airway and ventilation of the client. The nurse should secure the tube with tape or a device and check its position regularly using chest x-ray or end-tidal CO2 monitoring.

Choice E Reason: This choice is correct because elevating the head of the bed to at least 30° is an important intervention to prevent complications. Elevatin the head of the bed helps to reduce the risk of aspiration, which is the inhalation of gastric contents or secretions into the lungs. Aspiration can cause pneumonia, atelectasis, or respiratory failure in clients who are receiving mechanical ventilation.

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A nurse is preparing to administer an osmotic diuretic IV to a client with increased intracranial pressure. Which of the following should the nurse identify as the purpose of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is caring for a client who has sustained a head injury. The nurse notes the client's IV ﬂuids are infusing at 125 mL/hr. Which of the following is an appropriate action by the nurse?

Correct Answer is C

Explanation

A nurse is caring for a client who is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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