A nurse is collecting data from a client who is in renal failure. Which of the following findings should the nurse identify as a manifestation of hyperkalemia?

Dry mucous membranes

Hyperactive reflexes

Trousseau's sign

Irregular heart rate

Answer and Explanation

The Correct Answer is D

Choice A reason: Dry mucous membranes signal dehydration, not hyperkalemia directly. High potassium affects cardiac and nerve function, not mucosal hydration status in renal failure.

Choice B reason: Hyperactive reflexes occur in hypocalcemia, not hyperkalemia. Excess potassium depresses nerve and muscle activity, often reducing reflexes instead of enhancing them.

Choice C reason: Trousseau’s sign indicates hypocalcemia, with carpal spasm from cuff pressure. Hyperkalemia in renal failure doesn’t trigger this; it’s a calcium issue.

Choice D reason: Irregular heart rate, like bradycardia or arrhythmias, stems from hyperkalemia’s effect on cardiac conduction. In renal failure, potassium excess disrupts rhythms critically.

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Correct Answer is B

Explanation

Choice A reason: Calcium-fortified juice binds doxycycline, reducing absorption via chelation in the gut. Scientifically, tetracyclines like doxycycline lose efficacy with divalent cations, worsening nausea without treating chlamydia, making this counterproductive to therapeutic goals and pharmacokinetics.

Choice B reason: Taking doxycycline with crackers minimizes gastric irritation, reducing nausea while maintaining absorption. Scientifically, light food buffers the stomach without significantly impairing tetracycline bioavailability, aligning with evidence-based advice to improve tolerability and adherence in chlamydia treatment.

Choice C reason: Lying down after doxycycline risks esophageal irritation or reflux, worsening nausea. Scientifically, upright posture post-dose prevents drug stasis, which can cause ulcers, making this contrary to safe administration practices for tetracyclines per clinical guidelines.

Choice D reason: Antacids with magnesium or aluminum bind doxycycline, decreasing absorption and efficacy. Scientifically, this interaction undermines chlamydia treatment, as tetracyclines require an acidic environment for uptake, rendering this incompatible with therapeutic success and worsening outcomes.

A. Impetigo contagiosa B. Neisseria gonorrhoeae C. Human papillomavirus D. Sarcoptes scabiei

Correct Answer is B

Explanation

Choice A reason: Impetigo is contagious but not typically reportable unless outbreak-related. It’s a local bacterial skin infection, lacking mandatory public health notification status.

Choice B reason: Neisseria gonorrhoeae, causing gonorrhea, is a reportable STI per CDC guidelines. Reporting tracks prevalence and prevents spread, a legal nursing duty.

Choice C reason: Human papillomavirus isn’t reportable; it’s common and vaccine-preventable. Public health focuses on trends, not individual cases, unlike gonorrhea’s urgency.

Choice D reason: Sarcoptes scabiei (scabies) requires outbreak reporting, not routine cases. It’s less systematically tracked than gonorrhea, a priority STI for notification.

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A nurse is collecting data from a client who is in renal failure. Which of the following findings should the nurse identify as a manifestation of hyperkalemia?

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