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Exhibits

The practical nurse (PN) notifies the healthcare provider that the client continues to have signs of fluid volume deficit. The health care provider prescribes a continuous infusion of isotonic fluids.

Which fluid(s) is/are classified as isotonic? Select all that apply.

50% dextrose

0.45% sodium chloride

20% dextrose

5% dextrose

5% dextrose with 0.45% sodium chloride

5% dextrose with lactated Ringer's

lactated Ringer's

0.9% sodium chloride

Answer and Explanation

Correct Answer : G,H

A. 50% dextrose
50% dextrose is not isotonic; it is a hypertonic solution. Hypertonic solutions have a higher concentration of solutes compared to the cells, causing water to move out of the cells and into the extracellular space, which does not treat fluid volume deficit effectively.
B. 0.45% sodium chloride
0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution. Hypotonic solutions have a lower concentration of solutes compared to the cells, which would cause water to move into the cells rather than stay in the extracellular space to address fluid volume deficit.
C. 20% dextrose
20% dextrose is a hypertonic solution. It contains a higher concentration of dextrose compared to the extracellular fluid, which draws water into the extracellular space but is not used for treating fluid volume deficits.
D. 5% dextrose
5% dextrose (D5W) is initially isotonic but becomes hypotonic once metabolized, as the dextrose is used up and only water remains. It is not suitable for continuous isotonic fluid therapy for fluid volume deficit.
E. 5% dextrose with 0.45% sodium chloride
5% dextrose with 0.45% sodium chloride is a hypertonic solution. While it starts isotonic, it becomes hypotonic once the dextrose is metabolized, making it unsuitable for long-term isotonic fluid replacement.
F. 5% dextrose with lactated Ringer's
5% dextrose with lactated Ringer's is a hypertonic solution. It contains both dextrose and electrolytes, which are not purely isotonic and may not be ideal for addressing fluid volume deficits on their own.
G. Lactated Ringer's
Lactated Ringer's is an isotonic solution. It has a similar osmolarity to plasma and is used for fluid volume replacement, helping to restore blood volume and maintain electrolyte balance.
H. 0.9% sodium chloride
0.9% sodium chloride, or normal saline, is an isotonic solution. It has the same osmolarity as plasma and is commonly used for fluid volume replacement and maintaining hydration

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Correct Answer is B

Explanation

A. Applying an ice pack can help manage pain and reduce swelling, but it is not the immediate priority. It is essential first to assess for complications that may require different interventions.
B. Observing the suture line for separation and hematoma formation is the first step in managing pain. Identifying possible complications like suture line issues or hematomas will guide the appropriate treatment.
C. Initiating warm sitz baths is beneficial for pain management and healing, but it should be done after assessing the episiotomy for potential complications. It is a supportive measure rather than an immediate assessment action.
D. Checking the medication administration record is relevant for managing pain but is secondary to assessing the condition of the episiotomy site. The first priority is to evaluate the site for any physical complications.

A. Acceleration. B. Nonreactive pattern. C. Fetal movement. D. Positive tracing.

Correct Answer is A

Explanation

A. Acceleration refers to a temporary increase in the fetal heart rate of at least 15 beats per minute above the baseline for at least 10 seconds. The observation of the fetal heart rate increasing 15 beats above baseline twice during the test indicates that accelerations are present, which is a reassuring sign of fetal well-being.
B. A nonreactive pattern would indicate that the test did not meet the criteria for accelerations or fetal heart rate reactivity, which is not the case here as the fetal heart rate did exhibit accelerations.
C. Fetal movement could contribute to accelerations but is not the term used to describe the findings of the test itself. The specific observation made was an increase in fetal heart rate, which is classified as an acceleration.
D. A positive tracing indicates that the nonstress test met criteria for fetal well-being, typically with at least two accelerations, but the correct term for the specific observation here is acceleration rather than describing the overall result.

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Exhibits The practical nurse (PN) notifies the healthcare provider that the client continues to have signs of fluid volume deficit. The health care provider prescribes a continuous infusion of isotonic fluids. Which fluid(s) is/are classified as isotonic? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) views the mid-line episiotomy of a client who reports pain in her stitches. Which action should the PN take first?

Correct Answer is B

Explanation

During a nonstress test of a 38-week client, the practical nurse (PN) observes the fetal heart rate increases 15 beats above baseline lasting 10 seconds twice during a 20-minute tracing. Which finding should the PN document in the electronic medical record?

Correct Answer is A

Explanation

An older adult client of a long-term care facility is awake at 0330 and wandering down the hall in unbuttoned pajamas. Which intervention should the practical nurse (PN) implement?

Which client information is most important for the practical nurse (PN) to consider when providing instructions to the unlicensed assistive personnel (UAP) about providing morning care to a postoperative client?

Exhibits The practical nurse (PN) performs a focused assessment and documents it in the computer. Select what items require immediate follow-up by the PN. Select all that apply.

Which location should the practical nurse (PN) palpate to determine if a client's submandibular lymph nodes are enlarged?

Exhibits Based on the current focused assessment, what prescriptions should the practical nurse (PN) ask the health care provider to add? Select all that apply.

The practical nurse (PN) administers an antibiotic to a client with a respiratory tract infection. To evaluate the medication's effectiveness, what laboratory values should the PN monitor? Select all that apply.

Exhibits

The practical nurse (PN) notifies the healthcare provider that the client continues to have signs of fluid volume deficit. The health care provider prescribes a continuous infusion of isotonic fluids.

Which fluid(s) is/are classified as isotonic? Select all that apply.