The healthcare provider ordered an IV solution for a dehydrated client with a skull fracture. The nurse knows which IV fluid would be contraindicated?

Normal saline

Dextrose in water 5%

Lactated Ringer's (LR)

Dextrose in normal saline

Answer and Explanation

The Correct Answer is B

Choice A reason: Normal saline is not contraindicated for a dehydrated client with a skull fracture. Normal saline is an isotonic solution that has the same concentration of solutes as the blood plasma. It can help restore fluid balance and prevent cerebral edema.

Choice B reason: Dextrose in water 5% is contraindicated for a dehydrated client with a skull fracture. Dextrose in water 5% is a hypotonic solution that has a lower concentration of solutes than the blood plasma. It can cause fluid to shift from the blood vessels into the brain cells, increasing the intracranial pressure and worsening the skull fracture.

Choice C reason: Lactated Ringer's (LR) is not contraindicated for a dehydrated client with a skull fracture. Lactated Ringer's (LR) is an isotonic solution that has the same concentration of solutes as the blood plasma. It can also provide electrolytes such as sodium, potassium, calcium, and lactate, which can help correct acid-base imbalances.

Choice D reason: Dextrose in normal saline is not contraindicated for a dehydrated client with a skull fracture. Dextrose in normal saline is a hypertonic solution that has a higher concentration of solutes than the blood plasma. It can cause fluid to shift from the brain cells into the blood vessels, reducing the intracranial pressure and cerebral edema.

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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.

A. You need to have your medications adjusted so you need to be admitted to the hospital for a complete workup. B. You build up too much urine in your bladder, which can cause you to get confused. C. Dehydration can cause changes that can result in confusion, so let's try to increase your fluid intake. D. Urinary tract infections are common and can cause confusion, so it's important not to urinate at night.

Correct Answer is C

Explanation

Choice A reason: This is not the best response because it is alarmist and does not address the client's concern. The nurse should not assume that the client needs to have their medications adjusted or be admitted to the hospital without further assessment.

Choice B reason: This is not the best response because it is inaccurate and does not explain the link between urine retention and confusion. The nurse should not imply that the client is causing their own confusion by not drinking enough water.

Choice C reason: This is the best response because it is accurate and educates the client on the effects of dehydration on the body. The nurse should encourage the client to drink more fluids throughout the day and offer strategies to make it easier for them to access the bathroom at night.

Choice D reason: This is not the best response because it is irrelevant and does not address the client's dehydration. The nurse should not suggest that the client has a urinary tract infection without evidence or testing. The nurse should also not discourage the client from urinating at night, as this can lead to other complications.

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The healthcare provider ordered an IV solution for a dehydrated client with a skull fracture. The nurse knows which IV fluid would be contraindicated?

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is C

Explanation

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