Nokea
The nurse cares for a client with a potassium of 3.1 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. The primary healthcare provider (PHCP) prescribed 40 mEq of intravenous (IV) potassium over four hours. Which assessment finding would indicate a therapeutic effect?
- A. normoactive bowel sounds
- B. flattened T-waves
- C. reduced deep tendon reflexes
- D. muscle cramping
Correct Answer: B
Rationale: Hypokalemia can cause peaked T-waves on ECG. A therapeutic effect of potassium administration would be normalization of ECG, indicated by flattened T-waves. Normoactive bowel sounds (A), reduced reflexes (C), and muscle cramping (D) are not specific indicators of corrected hypokalemia.
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The nurse is caring for a client with a sodium level of 130 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]. Which of the following medications may cause this abnormality? Select all that apply.
- A. Spironolactone
- B. Hydrochlorothiazide
- C. Prednisone
- D. Sodium polystyrene
- E. Tolvaptan
Correct Answer: B,E
Rationale: Hydrochlorothiazide and tolvaptan can cause hyponatremia by increasing sodium loss or water retention.
The following scenario applies to the next 1 items
The nurse in the emergency department (ED) is caring for a 78-year-old female client
Item 1 of 1
Nurses' Note
1355: Client was brought to the ED by the client's adult children, who reported that while she was visiting, she reported dizziness and seemed slightly confused. The adult child reports that the symptoms started one day ago. The client recently had a change in her blood pressure medication, with the physician increasing the dosage of her prescribed furosemide. Medical history of hypertension, hyperlipidemia, and osteoarthritis. Vital signs: T 100° F (37.8° C), P 104, RR 22, BP 110/66, pulse oximetry reading 95% on room air.
On assessment, the client is lethargic and oriented to person and place, but not time. The client's breathing appears unlabored with tachypnea. Clear lung sounds throughout all lung fields. Skin is warm, dry, and flaky. Peripheral pulses 1+ in all extremities. Aching pain reported in the hips and knees and rated 5 on a scale of 0 (no pain) to 10 (severe pain). Client was ambulated to the bathroom, where she urinated 300 mL of clear, yellow urine without any odor or particulates. 22-gauge peripheral venous access device (VAD) placed in right forearm.
Complete the sentence below by choosing from the list of options. Based on the client's..... and............. this client is at highest risk for........
- A. lung sounds
- B. vital signs
- C. pain level
- D. dosage increase of diuretic
- E. urinary infection.
- F. fluid volume deficit.
Correct Answer: B, D,F
Rationale: Increased furosemide dosage increases the risk of fluid volume deficit, as evidenced by dizziness and lethargy.
The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?
- A. WBC 19,000 mm3 [5,000-10,000 mm3]
- B. Hemoglobin 9 g/dL [Male: 14-18 g/dL (140-180 g/L) Female: 12-16 g/dL (120-160 g/L)]
- C. Calcium 8.6 mg/dL [9.0-10.5 mg/dL]
- D. Serum pH 7.33 [7.35-7.45]
Correct Answer: A
Rationale: Elevated WBC (19,000 mm3) suggests infection, a serious complication in peritoneal dialysis.
The nurse is caring for a client with nephrotic syndrome. Which of the following assessment findings would be expected? Select all that apply.
- A. Proteinuria
- B. Hypoalbuminemia
- C. Edema
- D. Hyperglycemia
- E. Jaundice
Correct Answer: A,B,C
Rationale: Nephrotic syndrome causes proteinuria, hypoalbuminemia, and edema due to glomerular damage and protein loss.
The nurse is caring for a client with end-stage renal disease who receives prescribed sevelamer. Which of the following findings would indicate a therapeutic response?
- A. Decreased serum calcium levels
- B. Increased hemoglobin and hematocrit
- C. Decreased serum potassium levels
- D. Decreased serum phosphorus levels
Correct Answer: D
Rationale: Sevelamer is a phosphate binder used to lower serum phosphorus levels in end-stage renal disease, making decreased phosphorus levels the therapeutic response. It does not directly affect calcium (A), hemoglobin/hematocrit (B), or potassium (C).