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 D

Explanation

Choice A Reason: This is incorrect because dextrose 5% in 0.9% sodium chloride is a hypertonic solution that can cause ﬂuid overload and pulmonary edema in a client who has burns.

Choice B Reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause ﬂuid shifts from the intravascular space to the interstitial space, resulting in hypovolemia and hypotension in a client who has burns.

Choice C Reason: This is incorrect because 0.9% sodium chloride is an isotonic solution that can cause hypernatremia and hyperchloremia in a client who has burns, as the ﬂuid loss from burns is greater than the sodium loss.

Choice D Reason: This is correct because lactated Ringer's is an isotonic solution that contains electrolytes similar to plasma, such as sodium, potassium, calcium, and chloride. It also contains lactate, which is converted to bicarbonate in the liver and helps correct the metabolic acidosis that occurs in a client who has burns.

A. Hypervolemia B. Metabolic alkalosis C. Low hemoglobin D. Hyperkalemia

Correct Answer is C

Explanation

Choice A Reason: This is incorrect because hypervolemia is a condition of excess ﬂuid volume in the body. A client who has an extensive burn injury is more likely to have hypovolemia, which is a condition of low ﬂuid volume, due to ﬂuid loss from the damaged skin and capillaries.

Choice B Reason: This is incorrect because metabolic alkalosis is a condition of high blood pH and high bicarbonate level. A client who has an extensive burn injury is more likely to have metabolic acidosis, which is a condition of low blood pH and low bicarbonate level, due to increased production of lactic acid and ketones from tissue hypoxia and breakdown.

Choice C Reason: This is correct because low hemoglobin is a common laboratory finding in a client who has an extensive burn injury. Hemoglobin is the protein in red blood cells that carries oxygen. A client who has an extensive burn injury may have low hemoglobin due to hemolysis, which is the destruction of red blood cells, or hemorrhage, which is the loss of blood.

Choice D Reason: This is incorrect because hyperkalemia is a condition of high blood potassium level. A client who has an extensive burn injury may have hyperkalemia in the early phase of injury, due to cell damage and potassium release, but it is usually transient and followed by hypokalemia, which is a condition of low blood potassium level, due to ﬂuid loss and potassium depletion.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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