A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

A nephrostomy tube to a drainage bag

An NG tube to suction

An indwelling urinary catheter to gravity drainage

A chest tube to water-seal drainage

Answer and Explanation

The Correct Answer is B

A. A nephrostomy tube to a drainage bag:
A nephrostomy tube drains urine from the kidney to a drainage bag. While it's essential for urinary drainage, it doesn't lead to significant potassium loss, as potassium is primarily excreted through the urine.

B. An NG tube to suction:
An NG tube (Nasogastric tube) is inserted through the nose into the stomach. When connected to suction, it can remove stomach contents, including gastric acid and potassium. Excessive suctioning can lead to significant potassium loss, potentially causing hypokalemia.

C. An indwelling urinary catheter to gravity drainage:
An indwelling urinary catheter drains urine from the bladder into a drainage bag by gravity. While potassium can be found in urine, the drainage through a catheter does not cause significant potassium loss unless there are underlying kidney issues, which are not specified in this scenario.

D. A chest tube to water-seal drainage:
A chest tube removes air or fluid from the pleural space around the lungs. While chest tubes are vital for lung expansion, they don't result in significant potassium loss as they are not connected to body fluids rich in potassium, like gastric acid or urine.

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Correct Answer is A

Explanation

A. Prior to percussing the abdomen:Auscultation should be performed before percussing or palpating the abdomen. Percussion and palpation can alter bowel activity, potentially leading to inaccurate assessment of bowel sounds.

B. Prior to inspecting the abdomen:Inspection should always be performed before auscultation when assessing the abdomen. This allows the nurse to observe any visible abnormalities, such as distention or skin changes, without altering bowel activity. Auscultation should follow inspection.

C. After checking for kidney tenderness:Checking for kidney tenderness (e.g., costovertebral angle tenderness) involves percussing the back and is not part of the sequence of a standard abdominal exam. It does not precede auscultation.

D. After palpating the abdomen:
Palpation can stimulate or alter bowel sounds, potentially leading to an inaccurate assessment. Therefore, auscultation should always occur before palpation.

A. Check the client for a positive Chvostek’s sign B. Discontinue the TPN infusion. C. Request a potassium replace D. Administer glucagon IM

Correct Answer is C

Explanation

A. Check the client for a positive Chvostek’s sign:
Chvostek's sign is a clinical sign of hypocalcemia, not related to the given laboratory values. The symptoms include facial muscle twitching when the facial nerve (VII) is tapped. There's no indication for this assessment based on the provided information.

B. Discontinue the TPN infusion:
The glucose level is within the normal range (70-99 mg/dL). Discontinuing TPN based solely on this glucose level is not warranted.

C. Request a potassium replacement:
The potassium level is low (normal range typically 3.5-5.0 mEq/L). Given the low potassium level, the nurse should plan to request a potassium replacement. Potassium is crucial for various physiological functions, and a deficiency can lead to significant complications.

D. Administer glucagon IM:
Glucagon is used to treat hypoglycemia, but the client's glucose level is within the normal range, so administering glucagon is not indicated.

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A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is checking a client's bowel sounds. At which of the following times should the nurse auscultate the client's abdomen?

Correct Answer is A

Explanation

A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

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