Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?
0.459% saline.
0.9% NaCl.
5% dextrose in 0.45% saline.
Dextran.
The Correct Answer is B
Choice A rationale:
0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.
Choice B rationale:
0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.
Choice C rationale:
5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.
Choice D rationale:
Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale:
Increased bilirubin levels can occur in thalassemia major due to the destruction of red blood cells, leading to elevated bilirubin, which is a breakdown product of hemoglobin. This elevation can contribute to jaundice and other symptoms.
Choice B rationale:
Thalassemia major leads to the destruction of red blood cells, causing the bone marrow to release more reticulocytes (immature red blood cells) into the bloodstream. Therefore, an increased reticulocyte level is expected in thalassemia major.
Choice C rationale:
Increased mean corpuscular volume (MCV) is not a typical finding in thalassemia major. Thalassemia major is characterized by microcytic (smaller than normal) red blood cells, leading to a decreased MCV.
Choice D rationale:
Thalassemia major causes increased iron absorption by the intestines, leading to elevated total iron-binding capacity (TIBC) TIBC measures the body's capacity to bind and transport iron in the blood, and elevated levels are seen in conditions with increased iron demand, such as thalassemia major.
Correct Answer is A
Explanation
Choice B rationale:
A decrease in plasma renin levels is not a known cause of primary hypertension. Primary hypertension often has no identifiable cause, and it is a diagnosis of exclusion.
Choice C rationale:
Too much plaque in the blood vessels describes atherosclerosis, which is a risk factor for hypertension but not the direct cause of primary hypertension. Plaque buildup narrows arteries and increases resistance, contributing to elevated blood pressure.
Choice D rationale:
Kidney disease can cause secondary hypertension but is not the most common cause of primary hypertension. Primary hypertension, also known as essential hypertension, is the most common form, and its exact cause remains unknown in many cases.
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