A nurse is caring for a 78-year-old client who was recently admitted from the emergency room and is reporting weakness.

Exhibits

Select words from the choices below to fill in each blank in the following sentence.

The nurse has reviewed the client's medical record.

The client is at risk for developing metabolic acidosis hypernatremia
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and
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Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Correct choices are; Metabolic acidosis:

This can occur due to the client's diarrhea, leading to loss of bicarbonate (HCO3-) through the gastrointestinal tract. The ABG results show a pH slightly below normal (7.33) and a decreased bicarbonate level (19 mEq/L), indicative of metabolic acidosis.

Hypernatremia:

The client's sodium level is elevated at 149 mEq/L (normal range is 136-145 mEq/L). This indicates hypernatremia, which could be due to dehydration from diarrhea and possibly inadequate fluid intake.

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Correct Answer is A

Explanation

A. Hemoglobin levels are important for assessing oxygen-carrying capacity of the blood. While anemia can affect tissue oxygenation and exacerbate symptoms in heart failure, it is not directly related to the risk of digoxin toxicity.
B. Creatinine levels are used to assess kidney function. Impaired kidney function can affect the clearance of digoxin from the body, potentially increasing the risk of toxicity. However, potassium levels have a more direct impact on the risk of digoxin toxicity.
C. BUN levels are also used to assess kidney function. Similar to creatinine, impaired kidney function can affect digoxin clearance, but potassium levels are more directly related to the risk of digoxin toxicity.
D. Potassium levels are critical because hypokalemia (low potassium) can predispose the client to digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in cardiac cells. When potassium levels are low, digoxin can bind more readily to these pumps, leading to increased toxicity and potentially life-threatening arrhythmias such as ventricular tachycardia or ventricular fibrillation.

A. "It measures deficiencies in clotting factors." B. "If my levels are too low, I am at an increased risk for bleeding." C. "I will need to skip breakfast until after the test is complete." D. "This test will help my provider adjust my warfarin dosages."

Correct Answer is B

Explanation

A. It is particularly sensitive to deficiencies in clotting factors, but it does not measure the deficiencies themselves
B. The activated partial thromboplastin time (aPTT) test measures the effectiveness of the intrinsic and common pathways of the coagulation cascade.
C. There is no need to skip breakfast or alter diet for an aPTT test. It is not affected by food intake or fasting status.

D. While aPTT is used to monitor heparin therapy, it is not typically used to monitor warfarin (a vitamin K antagonist) therapy. Warfarin therapy is usually monitored using the prothrombin time (PT) and international normalized ratio (INR) tests.

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Naxlex Comprehensive Predictor Exams

A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Correct Answer is A

Explanation

A nurse is teaching a client scheduled for an activated partial thromboplastin time (aPTT). Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat having actions should the nurse explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

A nurse is caring for a client who is receiving a continuous IV infusion of heparin. Which of the following actions should the nurse take?

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

A nurse is admitting a client who has gastroenteritis and is reporting numbness and tingling of the toes and fingers. The nurse should recognize the client is experiencing which of the following acid-base imbalances?

A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

A nurse in a clinic is caring for a client who has a prescription for digoxin. Which of the following statements indicates the client is experiencing digoxin toxicity?