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
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.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Mental alertness is not affected by the administration of hypertonic solutions. Hypertonic solutions are fluids that have a higher concentration of solutes than the blood. They draw water out of the cells and into the blood vessels, increasing the blood volume and osmolarity.
Choice B reason: Decreased pulse is not a result of administering hypertonic solutions too quickly. On the contrary, hypertonic solutions can increase the pulse rate as they increase the blood volume and pressure.
Choice C reason: Decreased blood pressure is not a consequence of administering hypertonic solutions too quickly. Hypertonic solutions can raise the blood pressure as they increase the blood volume and osmolarity.
Choice D reason: Fluid overload is the correct answer. Administering hypertonic solutions too quickly can cause fluid overload, which is a condition where the body has too much fluid in the blood vessels. This can lead to symptoms such as edema, dyspnea, crackles, and weight gain. Fluid overload can also cause heart failure, pulmonary edema, and cerebral edema.
Correct Answer is D
Explanation
Choice A reason: H2-receptor antagonist and two antibiotics is not the correct combination for the "triple therapy" regimen. H2-receptor antagonists are drugs that block the action of histamine on the stomach cells, reducing the production of acid. They are used to treat peptic ulcers, but they are not effective against H. pylori bacteria. The "triple therapy" regimen requires an antibiotic to kill the bacteria, and a proton-pump inhibitor to reduce the acid secretion and promote healing.
Choice B reason: Two proton-pump inhibitors and an antibiotic is not the correct combination for the "triple therapy" regimen. Proton-pump inhibitors are drugs that block the enzyme that produces acid in the stomach, lowering the acidity and allowing the ulcer to heal. They are used to treat peptic ulcers, but they are not enough to eradicate H. pylori bacteria. The "triple therapy" regimen requires two antibiotics to kill the bacteria, and one proton-pump inhibitor to reduce the acid secretion and promote healing.
Choice C reason: H2-receptor antagonist, proton pump inhibitor, and an antibiotic is not the correct combination for the "triple therapy" regimen. H2-receptor antagonists and proton-pump inhibitors have similar effects on the stomach acid, but they work in different ways. They are both used to treat peptic ulcers, but they are not necessary to use together. The "triple therapy" regimen requires two antibiotics to kill the bacteria, and one proton-pump inhibitor to reduce the acid secretion and promote healing.
Choice D reason: Proton-pump inhibitor and two antibiotics is the correct combination for the "triple therapy" regimen. Proton-pump inhibitors are drugs that block the enzyme that produces acid in the stomach, lowering the acidity and allowing the ulcer to heal. They are used to treat peptic ulcers, and they also enhance the effectiveness of the antibiotics. The "triple therapy" regimen requires two antibiotics to kill the H. pylori bacteria, and one proton-pump inhibitor to reduce the acid secretion and promote healing. The most common antibiotics used are amoxicillin, clarithromycin, and metronidazole.
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