Nokea
Which meal choice is most appropriate for a client on a low-sodium diet?
- A. Ham sandwich with mustard
- B. Tomato soup with crackers
- C. Spaghetti with meat sauce
- D. Grilled chicken breast with glazed carrots
Correct Answer: D
Rationale: Clients on restricted sodium diets should avoid processed, smoked, and pickled foods and those with sauces and condiments. Foods lowest in sodium include fish, poultry, and fresh produce. Grilled chicken breast with glazed carrots is the lowest in sodium.
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A nurse evaluates a client who is being treated for hypokalemia. Which findings indicate that treatment is effective? (Select all that apply.)
- A. Respiratory rate of 8 breaths/min
- B. Strong, productive cough
- C. Absent deep tendon reflexes
- D. Active bowel sounds
- E. U waves present on the ECG
Correct Answer: B,D
Rationale: A strong, productive cough indicates improved muscle strength, and active bowel sounds suggest resolution of hypokalemia-related gastrointestinal issues.
A nurse teaches clients at a community center about risks for dehydration. Which client is at greatest risk for dehydration?
- A. A 36-year-old who is prescribed long-term steroid therapy
- B. A 55-year-old receiving hypertonic intravenous fluids
- C. A 75-year-old who is cognitively impaired
- D. A 63-year-old with congestive heart failure
Correct Answer: C
Rationale: Older adults, because they have less total body water than younger adults, are at greater risk for development of dehydration. Anyone who is cognitively impaired and cannot obtain fluids independently or cannot make his or her fluid needs known is at high risk for dehydration.
A nurse is caring for a client who exhibits dehydration-induced confusion. Which intervention should the nurse implement first?
- A. Measure the client's pulse and blood pressure
- B. A 5-year-old who is cognitively impaired
- C. Applying oxygen by mask or nasal cannula
- D. Increase oral fluid intake
Correct Answer: D
Rationale: For a client with dehydration-induced confusion, the priority is to address the dehydration by increasing fluid intake to restore hydration status, which may help resolve confusion. Measuring vital signs, assessing cognitive status, or applying oxygen may be secondary actions but do not directly address the underlying cause of dehydration.
A nurse cares for a client who has a serum potassium of 7.5 mEq/L and is exhibiting cardiovascular changes. Which prescription should the nurse implement first?
- A. Prepare to administer sodium polystyrene sulfonate (Kayexalate) 15 g by mouth
- B. Provide a client healthy, low potassium diet
- C. Prepare to administer dextrose 20% and 10 units of regular insulin IV push
- D. Prepare the client for hemodialysis treatment
Correct Answer: C
Rationale: A client with a high serum potassium level and cardiac changes should be treated immediately to reduce the serum potassium level. Insulin with dextrose enhances potassium movement into cells, reducing serum levels quickly. This is the fastest and most immediate intervention.
A nurse is caring for a client who has a serum calcium level of 14 mg/dL. Which provider order should the nurse implement first?
- A. Encourage oral fluid intake
- B. Connect the client to a cardiac monitor
- C. Assess the client's urine output
- D. Administer oral calcitonin (Calcimar)
Correct Answer: B
Rationale: This client has hypercalcemia. Elevated serum calcium levels can decrease cardiac output and cause cardiac dysrhythmias. Connecting the client to a cardiac monitor is a priority to assess for lethal cardiac changes.