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:
Hypotonic and will move fluid out of the vascular space.
Hypertonic and will move fluid into the vascular space.
Isotonic and will expand the vascular space.
Isotonic and will have no effect on fluid movement.
The Correct Answer is C
Choice A reason: This is incorrect because 0.9% sodium chloride (normal saline) is an isotonic solution, not a hypotonic one. Isotonic solutions have the same concentration of solutes as blood plasma and do not cause fluid movement across the cell membrane.
Choice B reason:
This is incorrect because 0.9% sodium chloride (normal saline) is an isotonic solution, not a hypertonic one. Hypertonic solutions have a higher concentration of solutes than blood plasma and cause fluid to move out of the cells and into the vascular space.
Choice C reason:
This is correct because 0.9% sodium chloride (normal saline) is an isotonic solution that will expand the vascular space by adding fluid without changing the concentration of solutes. This is useful for patients with hyponatremia (low sodium level in the blood) who need to restore their fluid and electrolyte balance.
Choice D reason:
This is incorrect because 0.9% sodium chloride (normal saline) is an isotonic solution that will expand the vascular space by adding fluid without changing the concentration of solutes. It will not have no effect on fluid movement, as it will increase the intravascular volume.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Serum glucose 600 mg/dL. This is an expected finding for a client who has diabetic ketoacidosis (DKA) DKA results from a deficiency of insulin, which leads to hyperglycemia and ketosis. The normal range for serum glucose is 70 to 110 mg/dL.
Choice B reason:
Serum bicarbonate 28 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences ketosis, which results in ketones in the urine and blood. The nurse should expect a client who has DKA to have an HCO3- less than 15 mEq/L. This decreased value is due to an increased production of ketones, which results in metabolic acidosis. The normal range for serum bicarbonate is 22 to 26 mEq/L.
Choice C reason:
Serum potassium 2.5 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences osmotic diuresis and subsequent dehydration, which can cause electrolyte imbalances. The nurse should expect a client who has DKA to have elevated serum potassium levels due to the movement of potassium from the intracellular to the extracellular space in response to acidosis. The normal range for serum potassium is 3.5 to 5 mEq/L.
Choice D reason:
Serum sodium 150 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences osmotic diuresis and subsequent dehydration, which can cause electrolyte imbalances. The nurse should expect a client who has DKA to have decreased serum sodium levels due to the dilutional effect of excess glucose in the blood. The normal range for serum sodium is 136 to 145 mEq/L.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A reason:
Jugular vein distension is a sign of fluid overload because it indicates increased pressure in the right atrium and superior vena cava due to excess blood volume.
Choice B reason:
Weight gain of 2 kg in one day is a sign of fluid overload because it reflects fluid retention in the body. A weight gain of 1 kg (2.2 lb) is equivalent to 1 L of fluid.
Choice C reason:
Decreased hematocrit is a sign of fluid overload because it indicates hemodilution or dilution of the blood due to excess fluid in the intravascular space.
Choice D reason:
Bounding pulse is a sign of fluid overload because it reflects increased cardiac output and stroke volume due to excess blood volume.
Choice E reason:
Flat neck veins are not a sign of fluid overload, but rather a sign of fluid deficit or dehydration. In fluid overload, neck veins will be distended or elevated.
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