A nurse in an urgent care clinic is collecting data from a client who reports having diarrhea for the past 3 days. Which of the following findings indicates hypokalemia?

Pitting edema

Diplopia

Muscle weakness

Hyperactive bowel sounds

Answer and Explanation

The Correct Answer is C

A nurse collecting data from a client who reports having diarrhea for the past 3 days should identify that muscle weakness is a symptom of hypokalemia. Hypokalemia is a condition in which the blood potassium level is low and can be caused by excessive ﬂuid loss through diarrhea. Potassium helps regulate muscle contractions, so when blood potassium levels are low, muscles may produce weaker contractions which result in muscle weakness.

The other options are not typical symptoms of hypokalemia.

a) Pitting edema is not a typical symptom of hypokalemia.

b) Diplopia is not a typical symptom of hypokalemia.

d) Hyperactive bowel sounds are not a typical symptom of hypokalemia.

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Correct Answer is C

Explanation

MDMA, commonly known as ecstasy or Molly, is a stimulant drug that affects the central nervous system. It primarily acts on serotonin, dopamine, and norepinephrine neurotransmitters. The use of MDMA can lead to altered perception, increased sensory awareness, and hallucinations. Hallucinations may involve visual, auditory, or tactile sensations that are not based on reality.

The other findings mentioned—hypothermia (abnormally low body temperature), somnolence (excessive sleepiness), and muscle weakness—are not typically associated with MDMA use. Instead, MDMA use may lead to increased body temperature (hyperthermia), increased energy levels, agitation, increased heart rate, and muscle tension.

A. A client who has heart failure and is incontinent of urine B. A client who has COPD and dementia and was agitated during the night shift C. A client who had a hip arthroplasty 10 days ago and reports pain with ambulation D. A client who had a cerebrovascular accident 6 months ago and reports constipation

Correct Answer is B

Explanation

The nurse should atend to the client who has COPD and dementia and was agitated during the night shift first. This client may be experiencing respiratory distress or other complications related to their COPD and requires immediate assessment and intervention.

a) A client who has heart failure and is incontinent of urine requires atention, but their needs are not as urgent as those of the client with COPD and agitation.

c) A client who had a hip arthroplasty 10 days ago and reports pain with ambulation requires atention, but their needs are not as urgent as those of the client with COPD and agitation.

d) A client who had a cerebrovascular accident 6 months ago and reports constipation requires attention, but their needs are not as urgent as those of the client with COPD and agitation.

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A nurse in an urgent care clinic is collecting data from a client who reports having diarrhea for the past 3 days. Which of the following findings indicates hypokalemia?

Nursing Test Bank

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