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A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?
- A. Hyperkalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hypochloremia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. In hemodialysis, potassium levels can be elevated due to impaired renal excretion. High potassium can lead to muscle weakness and numbness. The client's K level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), confirming hyperkalemia. Na, Cl, and Ca levels are within normal limits, ruling out hypernatremia, hypochloremia, and hypocalcemia as the client's primary electrolyte imbalance. Monitoring and managing hyperkalemia are crucial to prevent life-threatening complications like cardiac arrhythmias.
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Which of the following would the nurse use to document a finding that the patient’s ear is draining?
- A. Otorrhea
- B. Otalgia
- C. Ototoxic
- D. Tinnitus
Correct Answer: A
Rationale: The correct answer is A: Otorrhea. Otorrhea refers to the discharge of fluid from the ear, indicating an abnormal finding of ear drainage. This term specifically describes the symptom of ear drainage, making it the most appropriate choice for documenting this finding. Otalgia (choice B) refers to ear pain, ototoxic (choice C) refers to substances that are harmful to the ear, and tinnitus (choice D) refers to ringing in the ears, none of which accurately describe ear drainage. Therefore, the correct choice is A as it specifically addresses the symptom of ear drainage.
A client agreed to become an organ donor is pronounced dead. What is the most important factor in selecting a transplant recipient?
- A. Blood relationship
- B. Compatible blood and tissue types
- C. Sex and size
- D. Need
Correct Answer: B
Rationale: The correct answer is B: Compatible blood and tissue types. This is crucial to minimize the risk of rejection and ensure a successful transplant. Matching blood and tissue types help prevent the recipient's immune system from attacking the new organ. Blood relationship (A) is not as important as compatibility. Sex and size (C) are important considerations for certain transplants but not the most crucial factor. Need (D) is relevant but does not outweigh the importance of compatibility to ensure a successful transplant.
A patient teaching plan should include which of the ff. lifestyle modifications to help control hypertension?
- A. Regular aerobic exercise
- B. Three alcoholic beverages per day
- C. Low-tar cigarettes
- D. Daily multivitamin supplements
Correct Answer: A
Rationale: Step 1: Regular aerobic exercise helps lower blood pressure by improving heart health and circulation.
Step 2: Exercise reduces stress and promotes weight loss, factors that contribute to hypertension control.
Step 3: Alcohol consumption can raise blood pressure and should be limited or avoided.
Step 4: Smoking and using low-tar cigarettes can still raise blood pressure and have other negative health effects.
Step 5: Daily multivitamin supplements do not directly impact blood pressure control.
Before a cancer receiving total parenteral nutrition (TPN) resumes a normal diet, the nurse teaches him about dietary sources of minerals. Which foods are good sources of zinc?
- A. Fruits and yellow vegetables
- B. Fruits and green vegetables
- C. Yeast and legumes
- D. Whole grains and meats
Correct Answer: D
Rationale: The correct answer is D: Whole grains and meats. Zinc is found in high amounts in these foods. Meats, especially red meats and seafood, are rich sources of zinc. Whole grains like wheat, rice, and oats also contain significant amounts of zinc. Other choices are incorrect because fruits and vegetables are not typically good sources of zinc. Yeast and legumes are good sources of other minerals but not specifically zinc. It is important for the cancer patient to consume zinc-rich foods to support their immune system and overall health during recovery.
A 68-year old client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse would suspect which of the following disorders?
- A. Diabetes mellitus
- B. Hypoparathyroidism
- C. Diabetes insipidus
- D. Hyperparathyroidism
Correct Answer: D
Rationale: The correct answer is D: Hyperparathyroidism. This disorder is characterized by excessive secretion of parathyroid hormone, leading to increased calcium levels in the blood. The symptoms described in the question - bone pain, weakness, irritability, and depression - are all associated with hypercalcemia, a common manifestation of hyperparathyroidism. Additionally, the client's anorexia and increased urination can be attributed to the effects of hypercalcemia on the gastrointestinal and renal systems. Diabetes mellitus (choice A) involves high blood sugar levels and is not associated with the symptoms described. Hypoparathyroidism (choice B) is characterized by low levels of parathyroid hormone and calcium, leading to different symptoms such as muscle cramps and seizures. Diabetes insipidus (choice C) is a disorder of water balance characterized by excessive thirst and urination, not the symptoms presented in the question.