The nurse is caring for a patient with severe burns who is receiving IV fluid resuscitation with lactated Ringer's solution. The nurse understands that this type of solution is used for this patient because it:

Provides free water and replaces electrolytes.

Expands intravascular volume and replaces electrolytes.

Pulls fluid into the vascular space from the cells.

Moves fluid into the cells to replace cellular dehydration.

Answer and Explanation

The Correct Answer is B

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Correct Answer is B

Explanation

Choice A reason:

The client reports increased thirst. This is not an indication that the medication was effective, because increased thirst can be a sign of dehydration or electrolyte imbalance caused by excessive diuresis. Furosemide can cause loss of water and sodium, potassium, calcium, magnesium, and chloride in the urine.

Choice B reason:

The client's urine output is 250 mL/hr. This is an indication that the medication was effective, because furosemide is a loop diuretic that inhibits the reabsorption of sodium and water in the ascending limb of the loop of Henle, resulting in increased urine output and decreased fluid volume. A normal urine output is about 30 to 60 mL/hr, so a urine output of 250 mL/hr indicates a significant diuretic effect.

Choice C reason:

The client's heart rate is 100/min. This is not an indication that the medication was effective, because a high heart rate can be a sign of hypovolemia, hypotension, or cardiac stress caused by furosemide. Furosemide can lower the blood pressure and reduce the preload and afterload on the heart, but it can also trigger compensatory mechanisms such as increased sympathetic activity and renin-angiotensin-aldosterone system activation, which can increase the heart rate.

Choice D reason:

The client's weight is unchanged. This is not an indication that the medication was effective, because weight loss is expected with furosemide therapy due to fluid removal. Furosemide can cause a rapid and significant reduction in fluid volume, which can be measured by daily weight changes. A weight loss of 1 kg corresponds to a fluid loss of about 1 L.

A. Decreased serum pH. B. Increased serum calcium. C. Decreased serum magnesium. D. Increased serum bicarbonate.

Correct Answer is C

Explanation

Choice A: Decreased serum pH. This is incorrect because hypokalemia usually causes increased serum pH, not decreased. This is because low potassium levels can lead to metabolic alkalosis, a condition where the blood is too alkaline due to loss of acid from the body. This can happen in cases of vomiting, diuretic use, or mineralocorticoid excess.

Choice B:

Increased serum calcium. This is incorrect because hypokalemia does not directly affect serum calcium levels. However, hypokalemia can cause hypomagnesemia, or low magnesium levels, which can in turn cause hypercalcemia, or high calcium levels. This is because magnesium is needed for the secretion of parathyroid hormone (PTH), which regulates calcium balance in the body. Low magnesium levels can lead to increased PTH secretion and increased calcium reabsorption from the bones and kidneys.

Choice C:

Decreased serum magnesium. This is correct because hypokalemia and hypomagnesemia often occur together, especially in cases of chronic diarrhea, malabsorption, alcoholism, or diuretic use. This is because potassium and magnesium are both lost in the urine or stool when these conditions are present. Hypomagnesemia can also cause hypokalemia by impairing the reabsorption of potassium in the kidneys and increasing the entry of potassium into the cells.

Choice D:

Increased serum bicarbonate. This is incorrect because hypokalemia usually causes decreased serum bicarbonate, not increased. This is because low potassium levels can lead to metabolic acidosis, a condition where the blood is too acidic due to accumulation of acid in the body. This can happen in cases of diabetic ketoacidosis, renal tubular acidosis, or chronic kidney disease.

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The nurse is caring for a patient with severe burns who is receiving IV fluid resuscitation with lactated Ringer's solution. The nurse understands that this type of solution is used for this patient because it:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is evaluating a client who has fluid volume overload and received furosemide 40 mg IV bolus 1 hr ago. Which of the following findings indicates that the medication was effective?

Correct Answer is B

Explanation

A nurse is reviewing laboratory results for a client who has hypokalemia. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory results of a client who has chronic kidney disease and notes that the serum phosphate level is elevated. The nurse should anticipate that which of the following electrolyte levels will be decreased?

The nurse is preparing to insert a central venous catheter into a patient's right internal jugular vein using ultrasound guidance. What is an important step that the nurse should perform before inserting the catheter?

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse report to the provider? (Select all that apply.)

A nurse is evaluating the effectiveness of fluid therapy for a client who has hypernatremia. Which of the following findings indicates improvement? (Select all that apply.)

A nurse is administering albumin to a client who has hypovolemic shock due to hemorrhage. The nurse understands that albumin is which of the following types of solutions?

The nurse is preparing to hang a bag of 0.9% sodium chloride (normal saline) for a patient who has hyponatremia. The nurse knows that this type of solution is:

A nurse is planning care for a client who has hyponatremia and is receiving IV fluid therapy with 3% sodium chloride solution. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

A nurse is planning care for a client who has overhydration and hyponatremia. Which of the following actions should the nurse include in the plan? (Select all that apply.)