Nokea
The nurse is reviewing the assignment for the shift and will be caring for the following clients. Which client is at risk for hypokalemia? A client with
- A. hyperemesis gravidarum.
- B. end-stage renal failure.
- C. diabetic ketoacidosis.
- D. third-degree burns.
Correct Answer: A
Rationale: Hyperemesis gravidarum causes potassium loss through vomiting, increasing hypokalemia risk.
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The nurse is assessing a client's electrocardiogram (ECG) monitoring and notices U-waves. Which electrolyte abnormality may cause this finding?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia causes U-waves on ECG due to altered cardiac repolarization.
The nurse is placing a client with chronic kidney disease on a cardiac monitor. What is the reason for this action?
- A. Clients with chronic kidney disease are prone to hypertension
- B. Hyperkalemia may result in dysrhythmias
- C. Cardiac monitoring is necessary to evaluate the need for hemodialysis
- D. Clients with chronic kidney disease may experience false episodes of asystole
Correct Answer: B
Rationale: Hyperkalemia, common in CKD, can cause dysrhythmias, necessitating cardiac monitoring.
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.
A newly hired nurse is caring for a client who is receiving prescribed total parenteral nutrition (TPN) therapy. The nurse preceptor should intervene if the newly hired nurse?
- A. wears a surgical mask while changing the client's central vascular access dressing.
- B. obtains the client's capillary blood glucose every four to six hours.
- C. spikes and primes a new bag of TPN without an inline filter.
- D. continues the infusion via an infusion pump while the client is receiving a computed tomography scan.
Correct Answer: C
Rationale: TPN requires an inline filter to prevent infusion of particulate matter or air emboli. Not using a filter (C) is unsafe and requires intervention. Wearing a mask (A), checking glucose (B), and continuing infusion during a CT scan (D) are appropriate or not inherently unsafe.
The nurse reviews a client's laboratory data. Which laboratory data requires follow-up?
- A. Sodium
- B. Potassium
- C. Calcium
- D. BUN
- E. Creatinine
Correct Answer: B,C,D,E
Rationale: Abnormal potassium, calcium, BUN, and creatinine require follow-up due to potential renal or electrolyte imbalances.