Nokea
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.
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The nurse is assigned to care for a client with a sodium level of 122 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]. Which assessment findings does the nurse anticipate based on this lab result?
- A. Confusion
- B. Abdominal cramps
- C. Tall, peaked t-waves
- D. Hypoactive bowel sounds
- E. Nausea and vomiting
Correct Answer: A,B,E
Rationale: Hyponatremia causes confusion, abdominal cramps, and nausea/vomiting due to cerebral edema and gastrointestinal irritation.
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 teaching a group of students a potential cause of metabolic alkalosis. It would indicate a correct understanding if a student stated which condition could cause this acid-base imbalance?
- A. Hyperventilation
- B. Urinary retention
- C. Opioid toxicity
- D. Excessive vomiting
Correct Answer: D
Rationale: Excessive vomiting causes loss of hydrogen ions, leading to metabolic alkalosis.
The nurse is assessing assigned clients. Which client has a risk for urinary retention? Select all that apply.
- A. A 78-year-old man diagnosed with an enlarged prostate.
- B. An 83-year-old woman on bed rest.
- C. A 75-year-old woman with vaginal prolapse.
- D. An 89-year-old man with dementia.
- E. A 73-year-old woman on antihistamines to treat allergies.
- F. A 90-year-old man with difficulty walking to the restroom.
Correct Answer: A,C,D,E,F
Rationale: Enlarged prostate, vaginal prolapse, dementia, antihistamines, and mobility issues impair bladder emptying, increasing urinary retention risk.
The nurse cares for a client diagnosed with end-stage renal disease who just returned from initial hemodialysis. Which of the following assessment findings is of the highest concern?
- A. Headache and nausea
- B. Scant blood on the AV fistula
- C. Potassium 3.7 mEq/L (mmol/L) [3.5-5.0 mEq/L, mmol/L]
- D. Hemoglobin 8.8 g/dL [Male: 14-18 g/dL; Female: 12-16 g/dL, Female 115-155 g/L Male 125-170 g/L]
Correct Answer: A
Rationale: Headache and nausea may indicate dialysis disequilibrium syndrome, a serious complication requiring immediate attention.