A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?

Hyponatremia

Hyperkalemia

Hypovolemia

Hypervolemia

Answer and Explanation

The Correct Answer is D

A.   Hyponatremia is characterized by low sodium levels in the blood and is not typically associated with crackles in the lungs or elevated blood pressure.
B.   While hyperkalemia is a concern in end-stage kidney disease, it is not typically associated with crackles in the lungs or elevated blood pressure.
C.   Hypovolemia, or low blood volume, is not consistent with the client's reported symptoms of swelling in the lower extremities and crackles in the lungs.
D.   Hypervolemia, or fluid overload, is common in end-stage kidney disease and can manifest with symptoms such as shortness of breath, lower extremity edema, crackles in the lungs (due to pulmonary congestion), and elevated blood pressure.

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Correct Answer is B

Explanation

A. Dextran 40 is a plasma volume expander and not used for correcting hypernatremia.
B. Hypernatremia indicates a deficit of water relative to sodium. Providing hypotonic solutions like Dextrose 5 in water helps to dilute the sodium concentration in the body fluids, effectively treating hypernatremia.
C. Dextrose 10% in water is a hypertonic solution and would exacerbate hypernatremia by increasing the concentration of sodium in the body fluids.
D. 25% albumin is a hypertonic solution and would exacerbate hypernatremia by increasing the concentration of sodium in the body fluids.

A. Polyuria B. Muscle tremors C. Dry, sticky mucous membranes D. Negative Chvostek's sign

Correct Answer is B

Explanation

A. Polyuria (excessive urination) is not typically associated with low calcium levels. It may occur in conditions such as diabetes mellitus or diabetes insipidus.
B. Hypocalcemia (low calcium levels) can lead to neuromuscular irritability, which may manifest as muscle tremors or spasms. This is a classic sign of hypocalcemia.
C. Dry, sticky mucous membranes are more indicative of dehydration rather than hypocalcemia.
D. Negative Chvostek's sign means the absence of facial muscle twitching upon tapping the facial nerve, which is not expected in hypocalcemia.

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has hypernatremia. Which of the following IV solutions should the nurse plan to initiate?

Correct Answer is B

Explanation

A nurse is assessing a preschooler who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?

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