An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?
Hypercalcemia
Hypomagnesemia
Hyponatremia
Hypernatremia
The Correct Answer is C
A. Hypercalcemia: Hypercalcemia may cause confusion but is less likely associated with dehydration.
B. Hypomagnesemia: This can cause neuromuscular symptoms but is less commonly linked to confusion in dehydration.
C. Hyponatremia: Low sodium levels disrupt brain cell function, leading to confusion and neurological symptoms, which are common in dehydrated older adults.
D. Hypernatremia: While dehydration may cause hypernatremia, it is less likely to present with confusion in this context compared to hyponatremia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Dextrose 10% in water: Dextrose solutions provide calories but do not restore volume or replace electrolytes. They are not typically used in hypovolemic shock.
B. Lactated Ringer's: Lactated Ringer’s solution is an isotonic solution containing sodium, potassium, calcium, and lactate, which helps restore both fluid volume and electrolytes in the case of hypovolemic shock. It is commonly used while awaiting blood transfusions.
C. 0.33% sodium chloride: This is a hypotonic solution that can cause fluid to shift into cells and is not appropriate for fluid resuscitation in hypovolemia, which requires an isotonic solution.
D. 0.45% sodium chloride: This is a hypotonic solution as well, and it could worsen hypotension by causing fluid shifts into the cells, which is not ideal for treating hypovolemic shock.
Correct Answer is A
Explanation
A. Tap the face just below and in front of the ear: This is the correct technique for eliciting Chvostek’s sign, which involves tapping over the facial nerve. A positive sign (twitching of facial muscles) indicates hypocalcemia.
B. Inflate a blood pressure cuff around the upper arm for 4 minutes: This describes Trousseau’s sign, another test for hypocalcemia, where carpopedal spasm occurs due to ischemia.
C. Apply pressure over the ulnar and radial arteries: This describes Allen’s test, used to assess arterial blood flow, not calcium levels.
D. Forcefully dorsiflex the ankle when the knee is in an extended position: This describes Homan’s sign, which is used to assess for deep vein thrombosis (DVT), not hypocalcemia.
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