Nokea
The nurse is caring for a client on a medical floor. The nurse would recognize that which diagnosis increases the client's risk of developing hyperkalemia?
- A. Cushing's syndrome
- B. Acute renal failure
- C. Cystic fibrosis
- D. Bulimia nervosa
Correct Answer: B
Rationale: Acute renal failure impairs potassium excretion, leading to hyperkalemia.
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As a nurse, you are administering intravenous fluids to a client. Which of the following types of IV fluids would be classified as isotonic? Select all that apply.
- A. Normal saline
- B. 1/2 Normal saline
- C. Lactated ringers
- D. D10W
- E. 3% NaCl
Correct Answer: A,C
Rationale: Normal saline and lactated ringers are isotonic, matching plasma osmolality, unlike hypotonic (1/2 NS) or hypertonic (D10W, 3% NaCl) fluids.
The nurse is reviewing labs for a client with a serum potassium level of 3.3 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. The nurse should take which essential action based on this laboratory result?
- A. Educate the client on potassium-rich foods
- B. Implement continuous telemetry monitoring
- C. Obtain an order for calcium gluconate
- D. Assess the client's neurological status
Correct Answer: A
Rationale: Hypokalemia (low potassium) requires dietary education to increase potassium intake, as it does not typically necessitate telemetry or calcium.
The nurse has obtained a physician's order to obtain a clean catch urine specimen from a client. The nurse should instruct the client to obtain the urine sample
- A. from the first stream of urine from the bladder.
- B. midstream from the bladder.
- C. from the final stream of urine from the bladder.
- D. by emptying the entire volume of urine in the specimen cup.
Correct Answer: B
Rationale: Midstream urine collection minimizes contamination for accurate testing.
The nurse is reviewing the client's laboratory data. Which current prescription should the nurse clarify with the primary healthcare provider (PHCP)?
- A. Dextrose 5% in water (D5W)
- B. dexamethasone
- C. digoxin
- D. ergocalciferol
Correct Answer: A
Rationale: D5W is hypotonic and may worsen hyponatremia, requiring clarification in a client with low sodium levels.
The nurse is caring for a client with a kidney injury with a serum potassium level of 6.1 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. Which of the following actions is a priority?
- A. Obtain a prescription for a diuretic to increase urine output
- B. Check the client's sodium level
- C. Place the client on a cardiac monitor
- D. Encourage oral fluid intake
Correct Answer: C
Rationale: Hyperkalemia (6.1 mEq/L) poses a risk for cardiac dysrhythmias, making cardiac monitoring a priority.