BSF Staff Nurse - 2021
Medical & Surgical Nursing
Medium
Which of the following is least likely to be seen in a dehydrated patient?
Appeared in: BSF Staff Nurse - 2021
Explanation
- Dehydration involves the loss of plasma fluid from the blood, while the number of red blood cells remains constant.
- This process, known as hemoconcentration, leads to a higher concentration of red blood cells relative to the total blood volume.
- Consequently, the hematocrit level is expected to be increased in a dehydrated patient.
- A decreased hematocrit indicates the opposite condition, hemodilution (fluid overload), or a separate issue like anemia.
Why Other Options Were Wrong
- Option A: This is an expected sign of dehydration. The kidneys respond to fluid deficit by conserving water, which leads to a reduced volume of concentrated urine (oliguria).
- Option B: This is a classic compensatory sign of dehydration. The heart beats faster (tachycardia) to maintain blood pressure and cardiac output when circulating fluid volume is low.
- Option C: This can be a sign of dehydration. Fluid is essential for thermoregulation via sweating. Impaired sweating due to significant fluid loss can cause the body's core temperature to rise.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Clinical signs and symptoms of dehydration (fluid volume deficit) to guide bedside assessment, documentation, and the next nursing action.
- Nurses must be able to rapidly assess for dehydration, as it can progress to serious complications like hypovolemic shock, acute kidney injury, and electrolyte imbalances.
- Key nursing interventions include monitoring vital signs (especially heart rate and orthostatic blood pressure), strict intake and output measurement, and assessing skin turgor and mucous membranes.
- A urine output of less than 30 mL/hour in an adult is a critical sign of inadequate renal perfusion and must be addressed promptly.
How to Approach the Question
- First, understand the question's core concept, which is the physiological response to dehydration (fluid volume deficit).
- Note the negative framing: "least likely." This means you are looking for the option that does NOT fit with the clinical picture of dehydration.
- Evaluate each option based on the pathophysiology of dehydration:
- Low urine output: The body conserves water when dehydrated. This is an expected finding.
- Increased pulse rate: The heart compensates for low blood volume by beating faster. This is an expected finding.
- Elevated body temperature: Dehydration impairs the body's ability to cool itself. This is a possible finding.
Concept Tested & Keywords
- Concept Tested: Clinical signs and symptoms of dehydration (fluid volume deficit).
- Stem keywords: dehydrated patient, least likely, seen
- Lead-in keywords: least likely
- Negative lead-in flag: The question asks for the finding that is LEAST likely to occur, which is a negative framing. This requires evaluating each option to find the one that is inconsistent with the clinical picture of dehydration.
Question ID
Q5AkkgdAj1-h-6oFzNGWcz
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 574-576
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 152-154
E6 Medicine Harrison 22e Part 1 p. 388-390
Practise the full BSF Staff Nurse - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Fluid and Electrolytes: Balance and Distribution Questions
- All are crystalloid solution; except:
- ECG of the patient is showing ST depression, Prominent U wave and inverted T wave. Which of the electrolyte imbalance present?
- A patient reports calcium loss. What is the nursing intervention?
- The principle of hemodialysis in which the water is moving under high pressure to an area of lower pressure is:
- Measurement of arterial blood gas shows pH: 7.2, PaCO2 : 70 mm Hg, HCO3: 27 mmol/L and PaO2: 59 mm Hg. Interpret this:
- Fluid volume deficit or hypovolemia describes the loss of
- 100 mL fluid is given to patient and patient's CVP is 3 mm Hg, then what is the next intervention?
- A patient presents to the emergency department with a serum pH of 7.25, pCO2 of 40 mmHg, HCO3 of 22 mEq/L, sodium of 150 mEq/L, and chloride of 100 m…
- A 65-year-old patient is admitted to the hospital with a serum sodium level of 132 mmol/L. Despite being asymptomatic at admission, the patient begin…
- How would you most accurately assess fluid volume status in a patient with 20% total body surface area (TBSA) burns?
More BSF Staff Nurse - 2021 Questions
- Which of the following can cause abortion?
- Highest source of vitamin C is?
- Highest source of vitamin D is?
- How much calorie is provided by 1 gm protein?
- Which one is a type of mixed cranial nerve?
- How much weight is gained during pregnancy?
- Knee joint is which type of joint?
- Which one is an example of tertiary prevention?
- MI can be diagnosed by?
- Silent MI is commonly seen in?