A nurse is caring for a patient in acute renal failure who develops muscle weakness and an irregular heart rhythm. The provider prescribes an IV infusion of hypertonic glucose, regular insulin, and sodium bicarbonate. The nurse recognizes that these treatments are intended to manage which of the following complications?
Hypoglycemia
Hyperkalemia
Hypernatremia
Hypokalemia
The Correct Answer is B
Choice A reason: Hypoglycemia involves low blood glucose, causing symptoms like shakiness or confusion, not muscle weakness or arrhythmias. Hypertonic glucose and insulin would worsen hypoglycemia by increasing glucose uptake, and sodium bicarbonate is irrelevant. These symptoms and treatments align with hyperkalemia, not low glucose levels, in renal failure.
Choice B reason: Hyperkalemia, common in acute renal failure due to impaired potassium excretion, causes muscle weakness and cardiac arrhythmias by altering membrane potentials. Hypertonic glucose and insulin drive potassium into cells, while sodium bicarbonate corrects acidosis, stabilizing cardiac membranes, making this the targeted complication for the prescribed treatment.
Choice C reason: Hypernatremia (high sodium) causes neurological symptoms like confusion, not muscle weakness or arrhythmias. The prescribed treatments do not address sodium levels; insulin and glucose manage potassium, and bicarbonate corrects acidosis. Hypernatremia is not a primary concern in acute renal failure with these symptoms.
Choice D reason: Hypokalemia (low potassium) causes muscle weakness and arrhythmias but is rare in acute renal failure, where hyperkalemia is typical due to reduced excretion. The prescribed treatments aim to lower potassium, not increase it, making hypokalemia an incorrect target for this therapy in the context of renal failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Neighborhood watch programs enhance community safety but do not directly address mental health needs. They lack therapeutic components to manage symptoms or prevent decompensation, which are critical for preventing readmission in clients with mental health disorders, making this factor less relevant to sustained community stability.
Choice B reason: Taking meals at a food bank addresses nutritional needs but does not directly support mental health stability. While nutrition is important, it does not provide the therapeutic interventions or coping strategies needed to manage mental health disorders and prevent relapse or hospital readmission.
Choice C reason: Participation in treatment, such as therapy or medication adherence, directly addresses mental health symptoms, improving coping skills and emotional regulation. Consistent treatment reduces relapse risk, enhances stability, and supports community integration, making it the most effective factor for preventing readmission in clients with mental health disorders.
Choice D reason: A safe living environment reduces stress and safety risks but is secondary to active treatment. Without ongoing therapy or medication, environmental safety alone cannot manage symptoms or prevent decompensation, making it less critical than treatment participation for maintaining community stability and avoiding readmission.
Correct Answer is A
Explanation
Choice A reason: Silence allows the client to process trauma at their own pace, creating a safe, non-pressurized environment. Fearful clients may need time to feel secure before speaking. This technique fosters trust, encourages emotional expression, and is particularly effective in trauma, where verbalization can be challenging due to psychological distress.
Choice B reason: Giving information provides facts but may overwhelm a fearful client, who may not be ready to process details post-trauma. This technique is less effective for engagement, as it does not address emotional barriers or encourage self-expression, which are critical for therapeutic interaction in trauma recovery.
Choice C reason: Focusing directs the conversation to specific topics, which can feel intrusive for a traumatized client. It assumes readiness to discuss, potentially increasing anxiety or withdrawal. This technique is less effective than silence, which allows the client to initiate dialogue when emotionally prepared, fostering trust.
Choice D reason: Broad opening encourages the client to choose topics but may be too vague for a fearful, traumatized client, who may feel overwhelmed by the lack of structure. Silence is more effective, as it provides space for emotional processing without pressuring the client to verbalize prematurely.
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