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: Reintroducing foods that intensify symptoms one at a time is not an intervention that the nurse would recommend for a client with GERD. Foods that can trigger or worsen GERD symptoms include spicy, acidic, fatty, or fried foods, chocolate, coffee, alcohol, mint, garlic, and onion. The nurse would advise the client to avoid or limit these foods, not to reintroduce them.

Choice B reason: Promoting intake of food and fluids 1 to 2 hours before bedtime is not an intervention that the nurse would recommend for a client with GERD. Eating or drinking close to bedtime can increase the risk of acid reflux, as the stomach contents can flow back into the esophagus when the client lies down. The nurse would suggest the client to have smaller and more frequent meals, and to avoid eating or drinking at least 3 hours before bedtime.

Choice C reason: Maintaining an upright position following meals is an intervention that the nurse would recommend for a client with GERD. Keeping an upright posture can help prevent or reduce acid reflux, as gravity can help keep the stomach contents in place. The nurse would encourage the client to avoid bending, stooping, or lying down for at least 2 hours after eating.

Choice D reason: Increasing the amount of carbonated beverages is not an intervention that the nurse would recommend for a client with GERD. Carbonated beverages can increase the production of gas and stomach acid, which can cause bloating, belching, and acid reflux. The nurse would advise the client to drink water or other non-carbonated fluids, and to avoid drinking through a straw or chewing gum, which can also introduce air into the stomach.

A. The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your body will then begin to compensate. B. Your appendix doesn't play a major role so you won't notice any difference after your recovery from surgery. C. Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of this. D. Your small intestine will adapt over time to the absence of your appendix.

Correct Answer is D

Explanation

Choice A reason: This statement is not the best response for the nurse to give. The surgeon will not encourage the client to limit their fat intake after an appendectomy, as this has nothing to do with the appendix. The appendix is a small pouch attached to the beginning of the large intestine, not the small intestine where most of the fat digestion and absorption occurs.

Choice B reason: This statement is not the best response for the nurse to give. The appendix does play a role in the immune system and the gut microbiome, as it contains lymphoid tissue and beneficial bacteria. The client may notice some changes in their immunity or digestion after an appendectomy, especially if they have an infection or take antibiotics.

Choice C reason: This statement is not the best response for the nurse to give. The appendix does not affect the absorption of nutrients from the food the client eats, as it is not involved in the digestive process. The appendix is located at the end of the small intestine, where most of the nutrients have already been absorbed.

Choice D reason: This statement is the best response for the nurse to give. The appendix is not essential for survival, and the small intestine can adapt to its removal over time. The client may experience some temporary symptoms such as diarrhea, bloating, or gas after an appendectomy, but these usually resolve within a few weeks. The nurse should reassure the client that they can live a normal and healthy life without an appendix.

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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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Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client with GERD (gastroesophageal reflux disease). The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?

Correct Answer is C

Explanation

A client has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The client is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond?

Correct Answer is D

Explanation

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