Nokea
The nurse is caring for a client who prescribed a 40 mEq potassium chloride capsule for hypokalemia. The client reports difficulty swallowing capsules. Which action should the nurse take when administering this medication?
- A. Sprinkle the contents of the capsule onto a spoonful of soft food.
- B. Have the client chew the capsule prior to swallowing.
- C. Sprinkle the contents of the capsule into a cup of warm water.
- D. Put the capsule under the client's tongue and have it dissolve.
Correct Answer: A
Rationale: Potassium chloride capsules can be opened and the contents sprinkled onto a small amount of soft food, such as applesauce, to aid swallowing. Chewing the capsule (B) could cause irritation or release the medication too quickly. Dissolving in warm water (C) is not recommended as it may affect the medication's stability. Sublingual administration (D) is not appropriate for potassium chloride.
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The nurse reviews the lab values of a client and notes a serum sodium level of 125 mEq/L (mmol/L) [Reference range: 135-145 mEq/L (mmol/L)]. Which conditions does the nurse recognize as potential causes of this laboratory abnormality? Select all that apply.
- A. syndrome of inappropriate antidiuretic hormone (SIADH)
- B. diabetes Insipidus
- C. addison's disease (adrenal insufficiency)
- D. psychogenic polydipsia
- E. salt water drowning
Correct Answer: A,C,D
Rationale: SIADH causes water retention, diluting sodium. Addison's disease reduces aldosterone, leading to sodium loss. Psychogenic polydipsia causes excessive water intake, diluting sodium.
Which nursing assessment finding are consistent with hypocalcemia? Select all that apply.
- A. Chvostek's sign
- B. Grey-Turner's sign
- C. Homan's sign
- D. Trousseau's sign
- E. Numbness and tingling of the fingers and toes
Correct Answer: A,D,E
Rationale: Hypocalcemia causes Chvostek's sign, Trousseau's sign, and numbness/tingling due to neuromuscular irritability.
The nurse is caring for an assigned client. Which prescription requires clarification based on the laboratory data? See the exhibit. Select all that apply. Prescribed Medications: vancomycin 1-gram IVPB daily, furosemide 40 mg PO daily, 500 mL of 0.9% sodium chloride bolus x 1 dose, diltiazem XR 120 mg PO daily, Ketorolac 15 mg IV push every eight hours PRN pain. Laboratory Results: Sodium 145 mEq/L (145 mmol/L), Potassium 3.7 mEq/L (3.7 mmol/L), Calcium 9.3 mg/dL (2.32 mmol/L), BUN 25 mg/dL (8.93 mmol/L), Creatinine 2.1 mg/dL (185.64 umol/L)
- A. vancomycin 1-gram IVPB Daily
- B. furosemide 40 mg PO Daily
- C. 500 ml of 0.9% Saline IV Bolus x 1
- D. diltiazem XR 120 mg PO Daily
- E. ketorolac 15 mg IV Q 8 hours
Correct Answer: A,E
Rationale: Vancomycin (A) and Ketorolac (E) require clarification due to the elevated creatinine (2.1 mg/dL), indicating impaired renal function, which can increase the risk of toxicity for both drugs. Furosemide (B), saline bolus (C), and diltiazem (D) are not contraindicated with the given lab results.
The nurse is reviewing the concept of acute kidney injury (AKI) with a student nurse. Which of the following would be correct as a cause of prerenal AKI?
- A. nephrotoxicity
- B. bladder cancer
- C. contrast media
- D. hypovolemia
Correct Answer: D
Rationale: Hypovolemia causes prerenal AKI by reducing renal perfusion.
The nurse is reviewing the laboratory results of a client with renal failure. Which laboratory data requires immediate follow-up?
- A. Blood urea nitrogen 50 mg/dL [10-20 mg/dL]
- B. Serum potassium 6 mEq/L (mmol/L) [3.5-5.0 mEq/L]
- C. Arterial blood pH 7.30 [7.35-7.45]
- D. Hemoglobin 10.3 g/dL (1.03 g/L) [F: 12-16 g/dL (7.4 -9.9 mmol/L) M: 14-18 g/dL (8,7-11.2 mmol/L)]
Correct Answer: B
Rationale: Hyperkalemia (6 mEq/L) requires immediate follow-up due to the risk of cardiac dysrhythmias.