Among the following, which is not a clinical finding of a severely dehydrated patient?
Skin pallor and cool-to-touch skin
Pitting edema
Tachycardia with thready pulse
Lung sounds diminished with crackles upon auscultation
Urine Specific gravity of 1.035 D. Blood sodium 150 mEq/L
The Correct Answer is B
Choice A rationale
Skin pallor and cool-to-touch skin are common signs of severe dehydration. When the body is severely dehydrated, blood flow to the skin decreases, causing the skin to feel cool and look pale.
Choice B rationale
Pitting edema is not a clinical finding of severe dehydration. In fact, it’s quite the opposite. Pitting edema is a condition that causes swelling due to fluid accumulation, often due to conditions like heart failure, liver disease, or kidney disease.
Choice C rationale
Tachycardia with a thready pulse is a common sign of severe dehydration. The heart rate increases in an attempt to maintain blood flow to the organs, and the pulse may feel weak or thready due to low blood volume.
Choice D rationale
Lung sounds diminished with crackles upon auscultation is not typically associated with dehydration. This is more commonly seen in conditions affecting the lungs such as pneumonia or heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Memory loss is not typically associated with inadequate dietary intake of fiber. Memory loss can be a symptom of various conditions such as Alzheimer’s disease, dementia, or certain vitamin deficiencies, but it is not directly linked to fiber intake.
Choice B rationale
Bleeding gums are not typically a symptom of inadequate dietary intake of fiber. Bleeding gums are more commonly associated with conditions such as gingivitis or vitamin C deficiency, not a lack of dietary fiber.
Choice C rationale
Constipation is the correct answer. Inadequate intake of dietary fiber can lead to constipation. Dietary fiber adds bulk to the diet and helps prevent constipation by promoting regular bowel movements.
Choice D rationale
Brittle hair is not typically a symptom of inadequate dietary intake of fiber. Brittle hair can be a sign of malnutrition or lack of certain nutrients like protein, but it is not directly linked to fiber intake.
Correct Answer is A
Explanation
Choice A rationale
Changing gloves between tasks on the same client is a key infection control practice. This prevents cross-contamination between different body sites and reduces the risk of spreading infection.
Choice B rationale
Washing hands with alcohol-based hand rubs when caring for a client who has Clostridium difficile is not recommended. Clostridium difficile spores are not killed by alcohol-based hand rubs. Handwashing with soap and water is more effective.
Choice C rationale
Using alcohol-based hand rubs before administering eye drops for a client is a good practice, but it is not the most important information to reinforce. Hand hygiene is crucial in all aspects of patient care to prevent the spread of infection.
Choice D rationale
Keeping artificial nails trimmed short is a good practice, but it is not the most important information to reinforce. Artificial nails can harbor bacteria and other pathogens, increasing the risk of infection transmission.
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