Nokea
The nurse is caring for a client whose latest lab results show a serum calcium level of 13.2 mg/dL (3.3 mmol/L) [9-10.5 mg/dL, 2.12-2.52 mmol/L]. Which medication does the nurse expect to administer based on this lab result? Select all that apply.
- A. Phosphorus
- B. Calcitonin
- C. Vitamin D
- D. IV calcium gluconate
- E. IV Bisphosphonates
Correct Answer: B,E
Rationale: Calcitonin and bisphosphonates lower serum calcium levels in hypercalcemia by reducing bone resorption and increasing calcium excretion.
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The nurse is caring for a client who has just returned from an intravenous urography procedure. Which intervention should the nurse take to prevent post-procedure acute kidney injury?
- A. Assess the venipuncture site for redness
- B. Have the client obtain their daily weight for three days after the procedure
- C. Instruct the client to remain motionless
- D. Encourage the client to increase their fluid intake
Correct Answer: D
Rationale: Increased fluid intake helps flush contrast media, reducing the risk of AKI post-urography.
The nurse cares for a client with a potassium of 3.2 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. Which of the following medications may cause this abnormality?
- A. spironolactone
- B. triamterene
- C. prednisone
- D. lisinopril
Correct Answer: B
Rationale: Triamterene is a potassium-sparing diuretic that can cause hypokalemia by reducing potassium excretion. Spironolactone (A) also spares potassium but is less likely to cause hypokalemia. Prednisone (C) primarily affects glucose and sodium, not potassium. Lisinopril (D) may cause hyperkalemia, not hypokalemia.
The nurse is providing discharge instructions to a client prescribed phenazopyridine. Which of the following instructions should the nurse include?
- A. The amount of urine you void will increase
- B. Your urine will turn orange in color
- C. You may notice that your urine is malodorous
- D. Concentrated urine is an expected finding
Correct Answer: B
Rationale: Phenazopyridine causes orange-colored urine, a common side effect to inform clients about.
The nurse performs a physical assessment on a client and observes the client demonstrate palmar flexion while obtaining the blood pressure. The nurse should take which action?
- A. Obtain the blood pressure on the client's calf
- B. Request an order for a magnesium level
- C. Assess the client's orthostatic blood pressure
- D. Obtain capillary blood glucose (CBG)
Correct Answer: B
Rationale: Palmar flexion (Trousseau's sign) suggests hypocalcemia or hypomagnesemia, warranting a magnesium level check.
The nurse is assessing a client with suspected renal calculi. Which of the following findings would support a diagnosis of renal calculi? Select all that apply.
- A. hematuria
- B. nausea and vomiting
- C. hypotension
- D. dysuria
- E. increased urinary frequency
Correct Answer: A,B,D,E
Rationale: Renal calculi cause hematuria, nausea, vomiting, dysuria, and increased urinary frequency due to irritation and obstruction.