A nurse in the emergency department is caring for a client who is suspected to be in a cholinergic crisis. Which of the following factors should the nurse identify as a possible cause?

High purine diet

High protein diet

Not exercising enough

Taking too much of the prescribed medication

Answer and Explanation

The Correct Answer is D

Choice A reason: A high purine diet is more commonly associated with gout and hyperuricemia, not cholinergic crisis.

Choice B reason: A high protein diet is not directly related to cholinergic crisis. The crisis is related to medication levels rather than dietary factors.

Choice C reason: Not exercising enough is not a direct cause of cholinergic crisis. Physical activity levels do not impact the balance of acetylcholine in the body in this context.

Choice D reason: A cholinergic crisis occurs due to excessive accumulation of acetylcholine, often from taking too much of prescribed anticholinesterase medications. This can lead to overstimulation of the neuromuscular junction and symptoms such as muscle weakness and respiratory distress.

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Correct Answer is C

Explanation

Choice A reason: Prolonged bleeding is not a direct indicator of hyperkalemia. It is more commonly associated with coagulation disorders or conditions affecting blood clotting.

Choice B reason: Dry mucous membranes are more indicative of dehydration rather than hyperkalemia. Dehydration can result from a variety of conditions but is not specific to high potassium levels.

Choice C reason: Peaked T-waves on an electrocardiogram (ECG) are a classic sign of hyperkalemia. Elevated potassium levels affect the cardiac conduction system, leading to characteristic changes in the ECG, such as tall, peaked T-waves, widened QRS complexes, and flattened P-waves.

Choice D reason: Polyuria (excessive urination) is not typically associated with hyperkalemia. It is more commonly seen in conditions like diabetes mellitus or diabetes insipidus.

A. Brain natriuretic peptide (BNP) B. Creatinine level C. Blood urea nitrogen (BUN) D. Hemoglobin

Correct Answer is A

Explanation

Choice A reason: Brain natriuretic peptide (BNP) levels are elevated in heart failure. BNP is released by the ventricles in response to increased pressure and volume overload. Monitoring BNP levels helps assess the severity of heart failure and the effectiveness of treatment.

Choice B reason: Creatinine levels are used to assess kidney function but are not specific to heart failure. Elevated creatinine levels can indicate impaired kidney function but do not provide specific information about heart failure.

Choice C reason: Blood urea nitrogen (BUN) levels are used to assess kidney function and are not specific to heart failure. Elevated BUN levels can indicate impaired kidney function but do not provide specific information about heart failure.

Choice D reason: Hemoglobin levels indicate the oxygen-carrying capacity of the blood and are used to assess anemia but are not specific to heart failure.

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A nurse in the emergency department is caring for a client who is suspected to be in a cholinergic crisis. Which of the following factors should the nurse identify as a possible cause?

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