A nurse is reviewing the medical records of a client who has heart failure. The nurse should identify which of the following laboratory results as an indication that the client has fluid volume excess.

Urine specific gravity 1.015

Hematocrit 42%

Urine pH 6.5

BUN 5 mg/dL

Answer and Explanation

The Correct Answer is D

A. A urine specific gravity of 1.015 is within the normal range (1.005–1.030). While fluid volume excess may lead to a lower specific gravity due to urine dilution, this value does not indicate fluid overload and is considered normal.
B. A hematocrit level of 42% is within the normal range for adults (men: 38–50%, women: 35–45%). Hematocrit levels tend to decrease in fluid volume excess due to hemodilution, but this value does not suggest fluid overload.
C. A urine pH of 6.5 is within the normal range (4.5–8.0). Urine pH reflects the acid-base balance rather than fluid status and is not a reliable indicator of fluid volume excess.
D. A BUN level of 5 mg/dL is below the normal range (10–20 mg/dL). In fluid volume excess, the dilution of blood plasma can lead to decreased BUN levels. This low BUN value, in conjunction with clinical symptoms, supports the diagnosis of fluid volume excess.

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Correct Answer is D

Explanation

A. Provide an artificial voice box - This is not typically used for clients with aphasia as it does not address the communication barriers they face.
B. Avoid using facial gestures - Facial gestures can be a helpful non-verbal communication tool, especially for clients with aphasia, so avoiding them is not beneficial.
C. Speak to the client in a louder voice - Aphasia affects language processing, not hearing, so increasing volume does not aid in understanding.
D. Ask the client close-ended questions - This allows the client to respond with 'yes' or 'no', or other simple answers, which can be easier for someone with aphasia.

A. Body regulation of heat and cold increases with age. B. Circulation becomes less efficient with age. C. Increased metabolic rate occurs with age, and increasing body temperature. D. Sweat gland activity is increased with age.

Correct Answer is B

Explanation

A. Body regulation of heat and cold increases with age: This statement is incorrect. Age-related changes can lead to decreased efficiency in regulating body temperature, making older adults more susceptible to extreme temperatures.
B. Circulation becomes less efficient with age: Correct. With age, blood vessels can lose some of their elasticity, leading to decreased efficiency in circulating blood throughout the body. This can impact the ability to respond to temperature changes effectively.
C. Increased metabolic rate occurs with age, and increasing body temperature: This statement is incorrect. In general, metabolic rate tends to decrease with age, which can contribute to decreased heat production in older adults.
D. Sweat gland activity is increased with age: This statement is incorrect. Sweat gland activity tends to decrease with age, leading to decreased sweating and potential challenges in cooling the body during hot conditions.

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A nurse is reviewing the medical records of a client who has heart failure. The nurse should identify which of the following laboratory results as an indication that the client has fluid volume excess.

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