A nurse is caring for a client with chronic kidney disease (CKD) who presents with hyperkalemia. Which of the following interventions should the nurse implement first?

Administer sodium polystyrene sulfonate as prescribed.

Monitor the client’s cardiac rhythm.

Restrict dietary potassium intake.

Prepare the client for hemodialysis.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Administering sodium polystyrene sulfonate helps to lower potassium levels by exchanging sodium ions for potassium ions in the intestines. However, it is not the first intervention because it takes time to work and does not address the immediate risk of cardiac arrhythmias caused by hyperkalemia.
Choice B rationale
Monitoring the client’s cardiac rhythm is the first intervention because hyperkalemia can cause life-threatening cardiac arrhythmias. Continuous cardiac monitoring allows for the early detection and treatment of these arrhythmias, which is crucial for the client’s safety.
Choice C rationale
Restricting dietary potassium intake is an important long-term management strategy for hyperkalemia, especially in clients with chronic kidney disease. However, it does not address the immediate risk of cardiac arrhythmias and is not the first intervention.
Choice D rationale
Preparing the client for hemodialysis is a definitive treatment for hyperkalemia, especially in clients with chronic kidney disease. However, it is not the first intervention because it takes time to arrange and initiate dialysis. Immediate cardiac monitoring is necessary to manage the acute risk of arrhythmias.

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Correct Answer is B

Explanation

Choice A rationale
Deep vein thrombosis (DVT) can lead to pulmonary embolism but does not directly cause chest pain and shortness of breath.
Choice B rationale
Pulmonary embolus (PE) is characterized by chest pain, shortness of breath, and hemoptysis (coughing up blood), especially in patients on bed rest.
Choice C rationale
Anemia can cause fatigue and shortness of breath but not typically chest pain and hemoptysis.
Choice D rationale
Right heart failure can cause shortness of breath and edema but not typically chest pain and hemoptysis.

A. “I will check my blood sugar levels before each meal.”. B. “I can skip my medication if my blood sugar is normal.”. C. “I should follow a balanced diet and exercise regularly.”. D. “I need to monitor my feet for any cuts or sores.”.

Correct Answer is B

Explanation

Choice A rationale
Checking blood sugar levels before each meal is a good practice for managing diabetes and does not indicate a need for further teaching.
Choice B rationale
Skipping medication if blood sugar is normal indicates a misunderstanding of diabetes management. Medications should be taken as prescribed to maintain consistent blood sugar levels.
Choice C rationale
Following a balanced diet and exercising regularly are important components of diabetes management and do not indicate a need for further teaching.
Choice D rationale
Monitoring feet for cuts or sores is crucial for diabetes management to prevent complications like infections and ulcers.

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A nurse is caring for a client with chronic kidney disease (CKD) who presents with hyperkalemia. Which of the following interventions should the nurse implement first?

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Naxlex Comprehensive Predictor Exams

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Explanation

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