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Which nursing assessment finding are consistent with hypocalcemia? Select all that apply.
- A. Chvostek's sign
- B. Grey-Turner's sign
- C. Homan's sign
- D. Trousseau's sign
- E. Numbness and tingling of the fingers and toes
Correct Answer: A,D,E
Rationale: Hypocalcemia causes Chvostek's sign, Trousseau's sign, and numbness/tingling due to neuromuscular irritability.
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The nurse is assessing a client who was just diagnosed with acute pyelonephritis. Which of the following findings should the nurse expect to observe? Select all that apply.
- A. Costovertebral angle tenderness
- B. Jugular venous distention
- C. Fever and chills
- D. Urinary retention
- E. Dysuria
Correct Answer: A,C,E
Rationale: Pyelonephritis causes costovertebral angle tenderness, fever, chills, and dysuria due to kidney inflammation and infection.
A client with chronic kidney disease (CKD) is receiving hemodialysis treatment. Which of the following nursing interventions should be implemented for this client? Select all that apply.
- A. Monitor the client's blood pressure before, during, and after hemodialysis.
- B. Administer erythropoietin (EPO) as prescribed to stimulate red blood cell production.
- C. Restrict protein intake to minimize uremic symptoms.
- D. Assess the client's access site for signs of infection or thrombosis.
- E. Administer phosphate binders as prescribed to control serum phosphate levels.
- F. Encourage the client to consume a high-potassium diet to prevent electrolyte imbalances.
Correct Answer: A,B,D,E
Rationale: Monitoring BP, administering EPO, assessing the access site, and giving phosphate binders are standard CKD hemodialysis interventions. High-potassium diets are avoided.
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.
The nurse reviews the lab values of a client and notes a serum sodium level of 125 mEq/L (mmol/L) [Reference range: 135-145 mEq/L (mmol/L)]. Which conditions does the nurse recognize as potential causes of this laboratory abnormality? Select all that apply.
- A. syndrome of inappropriate antidiuretic hormone (SIADH)
- B. diabetes Insipidus
- C. addison's disease (adrenal insufficiency)
- D. psychogenic polydipsia
- E. salt water drowning
Correct Answer: A,C,D
Rationale: SIADH causes water retention, diluting sodium. Addison's disease reduces aldosterone, leading to sodium loss. Psychogenic polydipsia causes excessive water intake, diluting sodium.
The nurse is reviewing the client's laboratory data. Which current prescription should the nurse clarify with the primary healthcare provider (PHCP)?
- A. Dextrose 5% in water (D5W)
- B. dexamethasone
- C. digoxin
- D. ergocalciferol
Correct Answer: A
Rationale: D5W is hypotonic and may worsen hyponatremia, requiring clarification in a client with low sodium levels.