Nokea
After 5 days of diuretic therapy with 20mg of furosemide (Lasix) daily, a patient begins to exhibit fatigue, muscle cramping, and muscle weakness. These symptoms probably indicate that the patient is experiencing:
- A. Hypokalemia
- B. Hyperkalemia
- C. Anorexia
- D. Dysphagia
Correct Answer: A
Rationale: The symptoms of fatigue, muscle cramping, and muscle weakness in a patient after starting furosemide therapy are indicative of hypokalemia. Furosemide is a loop diuretic that can lead to potassium depletion, causing hypokalemia. Hypokalemia can manifest with muscle weakness, cramps, and fatigue due to alterations in neuromuscular function and decreased ATP production.
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All of the following interventions are correct when using the Z-track method of drug injection except:
- A. Prepare the injection site with alcohol
- B. Use a needle that is at least 1" long
- C. Aspirate for blood before injection
- D. Rub the site vigorously after the injection to promote absorption
Correct Answer: D
Rationale: When using the Z-track method of drug injection, it is important to prepare the injection site with alcohol to ensure cleanliness, use a needle that is at least 1" long to reach the muscle tissue, and aspirate for blood before injection to verify correct needle placement. However, rubbing the site vigorously after the injection is not recommended as it can cause medication to leak into subcutaneous tissue, compromising the medication's intended absorption and efficacy.
Which of the following conditions may necessitate fluid restriction?
- A. Fever
- B. Chronic Obstructive Pulmonary Disease
- C. Renal Failure
- D. Dehydration
Correct Answer: C
Rationale: Renal failure often necessitates fluid restriction to prevent fluid overload. In renal failure, the kidneys are unable to effectively filter and excrete excess fluids, leading to fluid accumulation in the body. Restricting fluid intake helps manage this condition by preventing further fluid buildup and complications such as edema and electrolyte imbalances.
Which of the following is a sign or symptom of a hemolytic reaction to a blood transfusion?
- A. Hemoglobinuria
- B. Chest pain
- C. Urticaria
- D. Distended neck veins
Correct Answer: A
Rationale: Hemoglobinuria is a characteristic sign of a hemolytic reaction to a blood transfusion. Hemolytic reactions can lead to the destruction of red blood cells, causing the release of hemoglobin into the urine, which presents as hemoglobinuria. Chest pain, urticaria, and distended neck veins are not specific signs of a hemolytic reaction and may be associated with other conditions or reactions.
After 1 week of hospitalization, Mr. Gray develops hypokalemia. Which of the following is the most significant symptom of his disorder?
- A. Lethargy
- B. Increased pulse rate and blood pressure
- C. Muscle weakness
- D. Muscle irritability
Correct Answer: C
Rationale: Muscle weakness is a hallmark symptom of hypokalemia. Hypokalemia refers to low levels of potassium in the blood, which can affect muscle function. The decreased potassium levels can lead to muscle weakness, cramping, and even paralysis. These symptoms can impact various muscle groups in the body, making muscle weakness the most significant symptom to monitor and address in patients with hypokalemia.
The healthcare provider orders an IV solution of dextrose 5% in water at 100ml/hour. What would the flow rate be if the drop factor is 15 gtt = 1 ml?
- A. 5 gtt/minute
- B. 13 gtt/minute
- C. 25 gtt/minute
- D. 50 gtt/minute
Correct Answer: C
Rationale: To determine the flow rate in drops per minute, multiply the ordered volume per hour by the drop factor (100 ml/hour x 15 gtt/ml = 1500 gtt/hour). Then, divide the result by 60 minutes to convert it to drops per minute (1500 gtt/hour · 60 minutes = 25 gtt/minute). Therefore, the correct answer is 25 gtt/minute.