A nurse is caring for a client who is taking lithium and reports starting a new exercise program.
The nurse should assess the client for which of the following electrolyte imbalances?

Hypomagnesemia.

Hypocalcemia.

Hyponatremia.

Hypokalemia.

Answer and Explanation

The Correct Answer is C

Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.

Strenuous exercise can also cause hyponatremia by increasing sweat loss and fluid intake. Therefore, a client who is taking lithium and starting a new exercise program is at risk of developing hyponatremia.

Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.

Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.

Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise.

However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are:

Sodium: 135-145 mmol/L

Magnesium: 0.7-1.1 mmol/L

Calcium: 2.1-2.6 mmol/L

Potassium: 3.5-5.0 mmol/L

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Correct Answer is D

Explanation

This is because a weight gain of 2.5 kg (5 Ib) in 2 days indicates a worsening of heart failure and fluid retention, which may require an adjustment of the diuretic dose or other medications.

The provider should be informed of this change as soon as possible to prevent further complications.

Choice A is wrong because teaching the client about foods low in sodium is not the first action the nurse should take.

While a low-sodium diet is important for heart failure patients, it is not an urgent intervention and it does not address the immediate problem of fluid overload.

Choice B is wrong because determining medication adherence by the client is not the first action the nurse should take.

While it is important to assess if the client is taking furosemide as prescribed, it is not an urgent intervention and it does not rule out other causes of fluid retention, such as renal impairment or disease progression.

Choice C is wrong because encouraging the client to dangle the legs while sitting in a chair is not the first action the nurse should take.

While this may help reduce edema in the lower extremities, it does not address the underlying cause of fluid overload and it may worsen pulmonary congestion by increasing venous return to the heart.

A. St. John’s Wort. B. Black cohosh. C. Coenzyme Q. D. Ginger root.

Correct Answer is A

Explanation

The nurse should advise the client to avoid taking St. John’s Wort with sertraline because it can increase the risk of a rare but serious condition called serotonin syndrome. Serotonin syndrome can cause symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhoea.

Choice B. Black cohosh is wrong because it is a herbal supplement that is used to treat menopausal symptoms and has no known interaction with sertraline.

Choice C. Coenzyme Q is wrong because it is a natural substance that is involved in energy production and has no known interaction with sertraline.

Choice D. Ginger root is wrong because it is a spice that is used to treat nausea and has no known interaction with sertraline.

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A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 Ib) since the last visit 2 days ago. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

A nurse is caring for a client who is taking sertraline and reports a desire to begin taking supplements. Which of the following supplements should the nurse advise the client to avoid?

Correct Answer is A

Explanation

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A nurse is caring for a client who is taking lithium and reports starting a new exercise program.
The nurse should assess the client for which of the following electrolyte imbalances?