A nurse is caring for a client who was involved in a motor vehicle accident and has lost approximately 1,550 mL of blood. The nurse should recognize that the client's shock will be classified as:

Correct Answer: C

Rationale: Class III hemorrhagic shock typically involves the loss of 1,500-2,000 mL of blood, which aligns closely with the approximately 1,550 mL of blood lost by the client in this scenario. Class III shock is considered severe and can lead to significant physiological consequences, including decreased blood pressure, increased heart rate, altered mental status, and potential organ dysfunction. Therefore, based on the amount of blood loss and severity of symptoms, the client's shock would be classified as Class III.

Correct Answer: D

Rationale: Vomiting can lead to dehydration and electrolyte imbalances due to the loss of fluids and electrolytes. In response to these physiologic changes caused by vomiting, aldosterone secretion will increase. Aldosterone is a hormone produced by the adrenal glands that acts on the kidneys to increase reabsorption of sodium and water, helping to maintain blood pressure and electrolyte balance. By increasing aldosterone secretion, the body aims to retain more sodium and water to counteract the effects of vomiting and prevent dehydration.

Correct Answer: B

Rationale: Polycystic kidney disease (PKD) is a genetic disorder that can be inherited by children if one or both parents have the gene mutation responsible for the condition. In cases where a parent has been diagnosed with PKD, their children are at risk of inheriting the faulty gene. As such, it is recommended for the children to undergo genetic testing and screening to identify any evidence of the disease early on. By identifying the gene mutation in the children, appropriate monitoring and management can be initiated, potentially leading to better outcomes and quality of life for the affected individuals. Therefore, genetic testing and screening are crucial in cases where there is a known genetic component to a disorder like PKD.

Correct Answer: B

Rationale: Given that the patient has a compound, open fracture of the femur and is undergoing immediate surgery, the most critical nursing diagnosis in the immediate postoperative period would be the risk for infection. Open fractures are particularly susceptible to infection due to the exposure of the fracture site to external contaminants. Postoperative care should prioritize infection prevention measures like sterile dressing changes, administration of prophylactic antibiotics, and close monitoring for signs of infection such as increased pain, redness, swelling, or drainage from the wound. Mitigating the risk of infection is crucial to prevent complications and promote optimal healing of the fracture. While the other diagnoses are relevant, addressing the risk for infection takes precedence in this scenario.