A patient with a serum sodium level of 128 mEq/L complains of headache, nausea, and confusion. Which of the following should be a priority?

Correct Answer: A

Rationale: The correct answer is A: Administer hypertonic saline. In a patient with hyponatremia (serum sodium <135 mEq/L), symptoms like headache, nausea, and confusion can indicate severe hyponatremia (<125 mEq/L) with potential for seizures and coma. Hypertonic saline is used to acutely raise sodium levels and treat symptoms of severe hyponatremia. Other options are incorrect because B (oral fluids) can worsen hyponatremia, C (potassium supplements) is not indicated, and D (Trendelenburg position) is not effective for treating hyponatremia.

Correct Answer: D

Rationale: The correct answer is D: 0.9% sodium chloride (normal saline). Rationale: Normal saline is the most appropriate IV solution for a dehydrated patient exhibiting tachycardia, hypotension, and dry mucous membranes because it is isotonic and helps restore intravascular volume effectively. The 0.9% sodium chloride solution closely resembles the electrolyte composition of extracellular fluid, making it suitable for fluid resuscitation in cases of dehydration. This solution helps to replenish both water and electrolytes, thereby improving the patient's hemodynamic status and overall hydration levels. Summary of other choices: A: 0.45% sodium chloride (half-normal saline) is hypotonic and may not effectively address the electrolyte imbalance and volume depletion seen in dehydration. B: The choice is missing, but it would be incorrect if it was an inappropriate solution for dehydration. C: Dextrose 5% in water (D5W) is a

Correct Answer: B

Rationale: The correct answer is B: Hypokalemia. Aggressive diuretic therapy can lead to potassium loss, causing muscle cramps and weakness. Potassium is essential for muscle function, and low levels can result in muscle-related symptoms. Hypernatremia (A) is an imbalance of high sodium levels, not typically associated with muscle cramps. Hyperkalemia (C) is high potassium levels and would not be expected with aggressive diuretic therapy. Hyponatremia (D) is low sodium levels, also not directly related to the symptoms described. Therefore, the most likely electrolyte imbalance in this scenario is hypokalemia.

Correct Answer: B

Rationale: The correct answer is B: Sodium pump. The sodium-potassium pump is a vital active transport mechanism in cells that moves sodium and potassium ions against their concentration gradients. It uses ATP to pump 3 sodium ions out of the cell and 2 potassium ions into the cell. This process helps maintain the cell's resting membrane potential and is crucial for nerve impulse transmission. Now, let's analyze why the other choices are incorrect: A: Filtration - Filtration is a passive process based on pressure differentials, not active transport involving specific pumps for sodium and potassium ions. C: Diffusion - Diffusion is a passive process where molecules move from an area of high concentration to low concentration, not involving the active transport of sodium and potassium against their gradients. D: Osmosis - Osmosis is the movement of water across a semi-permeable membrane, not the active transport of sodium and potassium ions by specific pumps like the sodium-potassium pump.

Correct Answer: C

Rationale: The correct answer is C because avocados and oranges are low in sodium, indicating understanding of a low-sodium diet. Dried fruits (A) are often high in sodium due to processing. Tomato juice (B) can be high in sodium unless it's low-sodium. A cheeseburger (D) typically contains high amounts of sodium, especially with extra ketchup. By choosing avocado and orange salad, the patient demonstrates good knowledge of low-sodium food choices.