Correct Answer: D

Rationale: The correct answer is D because upper extremity swelling could indicate a potential complication such as deep vein thrombosis, which is a serious condition requiring immediate attention to prevent further complications. Swelling can impede blood flow and lead to clot formation. A: The initial site dressing being 3 days old is concerning for infection but not an immediate threat. B: The PICC being inserted 4 weeks ago may increase infection risk but does not require immediate attention. C: A missing securement device may increase the risk of dislodgement but is not an immediate threat compared to potential vascular compromise indicated by upper extremity swelling.

Correct Answer: C

Rationale: The correct answer is C: Help distinguish reduced renal blood flow from decreased renal function. Rationale: 1. Oliguria is a decrease in urine output. 2. Fluid challenge with normal saline can help determine the cause of oliguria by assessing the response of the kidneys. 3. If the oliguria improves after the fluid challenge, it suggests reduced renal blood flow as the cause. 4. If oliguria persists, it indicates decreased renal function. Summary: A. Fluid challenge does not directly help in distinguishing between hyponatremia and hypernatremia. B. Evaluating pituitary gland function requires specific tests, not just a fluid challenge. D. Treating hypertension-induced oliguria may involve different interventions, not just a fluid challenge.

Correct Answer: D

Rationale: The correct answer is D: Shallow respirations. Hypermagnesemia can lead to respiratory depression due to its inhibitory effect on the central nervous system. Shallow respirations are a common respiratory manifestation of hypermagnesemia. Hypertension (choice A) is not typically associated with hypermagnesemia. Kussmaul respirations (choice B) are deep, rapid breathing patterns seen in metabolic acidosis, not hypermagnesemia. Increased deep tendon reflexes (DTRs) (choice C) are more indicative of hypomagnesemia, as magnesium deficiency can lead to hyperexcitability of nerves and muscles, resulting in increased DTRs.

Correct Answer: D

Rationale: The correct answer is D: Metabolic alkalosis. Furosemide, a loop diuretic, can lead to potassium depletion and metabolic alkalosis due to excessive loss of chloride and hydrogen ions. The nurse should assess for signs of metabolic alkalosis such as confusion, muscle weakness, and dysrhythmias to prevent complications. Respiratory acidosis and alkalosis are not directly related to furosemide therapy. Metabolic acidosis is less likely due to furosemide's mechanism of action.

Correct Answer: A

Rationale: The correct answer is A: Cimetidine. In metabolic alkalosis, the blood pH is elevated due to excess bicarbonate. Cimetidine is a histamine-2 receptor antagonist that can help decrease gastric acid production, which can contribute to alkalosis. Maalox (B) is an antacid used to treat acid-related conditions, not alkalosis. Potassium chloride elixir (C) is used to correct potassium imbalances, not directly related to alkalosis. Furosemide (D) is a loop diuretic used to treat fluid retention and edema, not specifically indicated for metabolic alkalosis.