A nurse is to administer a hypotonic solution to a patient with a critically high sodium. Which solution is hypotonic?

0.9% Sodium Chloride

Lactated Ringer's

D5W (5% Dextrose in Water)

0.45% Sodium Chloride

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not a correct answer because 0.9% Sodium Chloride is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice B reason: This is not a correct answer because Lactated Ringer's is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice C reason: This is not a correct answer because D5W (5% Dextrose in Water) is an isotonic solution when it is in the IV bag, but it becomes hypotonic once it enters the body, as the dextrose is rapidly metabolized and only water remains. However, it is not a preferred solution for a patient with critically high sodium, as it can cause cerebral edema and worsen the neurological status.

Choice D reason: This is a correct answer because 0.45% Sodium Chloride is a hypotonic solution, which means it has a lower osmolarity than the blood plasma. It causes fluid to shift from the extracellular to the intracellular compartment, which can help lower the sodium level and correct the fluid imbalance.

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Correct Answer is C

Explanation

Choice A reason: This is not a correct sign of hypervolemia. Increased thirst and dry mucous membranes are signs of dehydration or fluid volume deficit, which can occur due to excessive fluid loss or inadequate fluid intake.

Choice B reason: This is not a correct sign of hypervolemia. Low blood pressure and increased heart rate are signs of hypovolemic shock, which can occur due to severe fluid loss or hemorrhage.

Choice C reason: This is a correct sign of hypervolemia. Difficulty breathing and weight gain are signs of fluid overload, which can occur due to excessive fluid retention or impaired cardiac function. Difficulty breathing can be caused by pulmonary edema, which is the accumulation of fluid in the lungs. Weight gain can be caused by the increase in total body fluid.

Choice D reason: This is not a correct sign of hypervolemia. Dry cough and poor skin turgor are signs of dehydration or fluid volume deficit, which can occur due to excessive fluid loss or inadequate fluid intake.

A. Fatty stools B. Tenderness in the left upper abdomen C. Ecchymosis of the extremities D. Pale-colored urine

Correct Answer is A

Explanation

Choice A reason: This is a correct finding for a client with an obstruction of the common bile duct. Fatty stools are caused by the reduced or absent flow of bile into the intestine, which impairs the digestion and absorption of fats.

Choice B reason: This is not a correct finding for a client with an obstruction of the common bile duct. Tenderness in the left upper abdomen may indicate a problem with the spleen, the stomach, or the pancreas, but not the bile duct.

Choice C reason: This is not a correct finding for a client with an obstruction of the common bile duct. Ecchymosis of the extremities is a bruising of the skin due to bleeding under the surface. It may be caused by trauma, medication, or bleeding disorders, but not by bile duct obstruction.

Choice D reason: This is not a correct finding for a client with an obstruction of the common bile duct. Pale-colored urine is a sign of dilute or low concentration of urine, which may be caused by excessive fluid intake, diabetes insipidus, or kidney failure, but not by bile duct obstruction.

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A nurse is to administer a hypotonic solution to a patient with a critically high sodium. Which solution is hypotonic?

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