Which of the following statements about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?

Correct Answer: B

Rationale: For a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS), the correct statement is to administer 6L of IV fluid over the first 24 hours (option B). The management of HHNS focuses on correcting dehydration and hyperglycemia. The initial fluid resuscitation in HHNS aims to address the profound dehydration that occurs due to osmotic diuresis from hyperglycemia. The recommended rate is to administer 1 to 1.5 L/hour of IV fluid until the patient is hemodynamically stable and urine output is adequate. Administering fluid rapidly helps to address the hypovolemia and prevent complications associated with shock. Administering fluid too slowly may delay the correction of dehydration and lead to further complications.

Correct Answer: A

Rationale: The nurse will assess a loss of ability in the area of balance. Balance is an essential component of the physical function that allows individuals to maintain an upright posture and stability during movement. A loss of balance can significantly impact a person's mobility, coordination, and safety. Nurses often assess balance as part of their evaluations to identify any impairments that may affect a patient's independence and daily activities.

Correct Answer: D

Rationale: For an adult receiving total parenteral nutrition (TPN), it is essential for the nurse to monitor fluid and electrolyte levels closely. TPN provides all essential nutrients, including fluids and electrolytes, directly into the bloodstream. Monitoring these levels is crucial to prevent potential complications such as fluid overload, electrolyte imbalances, and hyperglycemia. Assessing and maintaining appropriate fluid and electrolyte balance are essential components of managing a patient receiving TPN to ensure optimal patient outcomes.

Correct Answer: C

Rationale: Before drawing blood from a central venous catheter like a Hickman type, it is essential to ensure that the catheter is patent and free of any clots. Flushing the catheter with a heparinized solution (to prevent clot formation) before withdrawing blood helps clear the catheter and ensures accurate blood sample collection. Removing clots or obstructions from the catheter is crucial to prevent complications and maintain the catheter's function. Therefore, it is important to first flush the catheter with a heparinized solution before drawing blood from it.

Correct Answer: D

Rationale: The correct answer is D) retinoblastoma. Retinoblastoma is least likely to occur in adults compared to children because it is a rare childhood eye cancer that typically affects children under the age of 5. This malignancy arises from the retina and is caused by genetic mutations. A) Acute Lymphoblastic Leukemia (ALL) is a common type of leukemia that can occur in both children and adults. It is more prevalent in children but can also affect adults. B) Osteosarcoma is a type of bone cancer that primarily occurs in children and young adults during periods of rapid bone growth. It is rare in older adults. C) Medulloblastoma is a type of brain cancer that mainly affects children, with peak incidences between 3-4 years old. It is very rare in adults. Educationally, understanding the age-specific prevalence of different malignancies is crucial for healthcare providers, especially those working with pediatric populations. Recognizing the typical age of onset for various cancers helps in early detection, diagnosis, and appropriate management. This knowledge enhances patient care and outcomes by enabling healthcare professionals to provide targeted and specialized care based on the specific needs of pediatric patients.