Nokea
The nurse is caring for a client with hyperkalemia. Which of the following treatments would the nurse recognize as appropriate options for treating this electrolyte imbalance? Select all that apply.
- A. Spironolactone
- B. Sodium polystyrene
- C. Regular insulin
- D. Hemodialysis
- E. Magnesium sulfate
Correct Answer: B,C,D
Rationale: Sodium polystyrene (B) binds potassium in the gut, regular insulin (C) shifts potassium into cells, and hemodialysis (D) removes potassium from the blood, all effective for hyperkalemia. Spironolactone (A) is a potassium-sparing diuretic and would worsen hyperkalemia. Magnesium sulfate (E) is not used for hyperkalemia.
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Which nursing intervention would be a priority for a patient receiving 3% saline maintenance fluids?
- A. Monitor serum HCO3-
- B. Monitor urine sodium
- C. Assess blood pressure
- D. Collect 24-hour urine output
Correct Answer: C
Rationale: 3% saline, a hypertonic solution, can cause fluid shifts, making blood pressure monitoring a priority.
The nurse understands that which of the following are complications of acute tubular necrosis (ATN)? Select all that apply.
- A. Metabolic acidosis
- B. High thyroxine levels
- C. Hyponatremia
- D. Decreased parathyroid levels
- E. Electrolyte imbalances
Correct Answer: A,C,E
Rationale: ATN causes metabolic acidosis, hyponatremia, and electrolyte imbalances due to impaired renal function.
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 is administering IV magnesium to a client with a magnesium level of 1.5 mEq/L (0.62 mmol/L) [1.5-2.5 mEq/L, 0.6-1.2 mmol/L]. You check on them halfway through the infusion, and they report that their face feels flushed. What is the priority nursing intervention?
- A. Slow down the infusion rate.
- B. Notify the primary healthcare provider (PHCP).
- C. Reassess the client when the infusion finishes.
- D. Stop the infusion.
Correct Answer: A
Rationale: Flushing is a common side effect of IV magnesium infusion and can often be managed by slowing the infusion rate to reduce symptoms. Stopping the infusion (D) or notifying the PHCP (B) is not necessary unless symptoms worsen. Reassessing later (C) delays intervention.
The nurse is reviewing the assessment data for a client with acute glomerulonephritis (AGN). Which of the following would be an expected finding?
- A. Ketonuria
- B. Hematuria
- C. Polyuria
- D. Glycosuria
Correct Answer: B
Rationale: Hematuria is a hallmark of acute glomerulonephritis due to glomerular inflammation.