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A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?

A client who is post-coronary artery bypass graft (CABG), has total cholesterol of 318 mg/dL, and is prescribed atorvastatin

A client who has pneumonia, a WBC count of 11,500/mm³, and is prescribed piperacillin

A client who has renal failure, a serum potassium of 5.8 mEq/L, and is prescribed sodium polystyrene sulfonate

A client who has anemia, hemoglobin of 11 g/dL, and is prescribed epoetin alfa

Answer and Explanation

The Correct Answer is C

Choice A Reason: This is incorrect because a client who is post-CABG and has high cholesterol is not in immediate danger, as atorvastatin is a long-term medication that lowers cholesterol and prevents cardiovascular complications.

Choice B Reason: This is incorrect because a client who has pneumonia and a slightly elevated WBC count is not in immediate danger, as piperacillin is an antibiotic that treats bacterial infections.

Choice C Reason: This is correct because a client who has renal failure and a high serum potassium level is in immediate danger, as sodium polystyrene sulfonate is an emergency medication that lowers potassium and prevents cardiac arrhythmias.

Choice D Reason: This is incorrect because a client who has anemia and a mild hemoglobin deficiency is not in immediate danger, as epoetin alfa is a long-term medication that stimulates red blood cell production and improves oxygen delivery.

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Correct Answer is A

Explanation

Choice A Reason: This is correct because an osmotic diuretic, such as mannitol, works by creating an osmotic gradient that draws ﬂuid from the brain tissue into the blood vessels, thereby reducing cerebral edema and intracranial pressure.

Choice B Reason: This is incorrect because an osmotic diuretic would decrease, not increase, the cell size in the brain by removing ﬂuid from the intracellular space.

Choice C Reason: This is incorrect because an osmotic diuretic would decrease, not expand, the extracellular ﬂuid volume by increasing the urine output and excreting excess ﬂuid from the body.

Choice D Reason: This is incorrect because an osmotic diuretic would not provide ﬂuid hydration, but rather cause ﬂuid loss and dehydration.

A. Hypomagnesemia B. Hyperkalemia C. Decreased creatinine level D. Increased glomerular filtration rate (GFR)

Correct Answer is B

Explanation

Choice A Reason: This choice is incorrect because hypomagnesemia is not a common finding in the oliguric phase of acute kidney injury. Hypomagnesemia is a condition in which the serum magnesium level is lower than normal (less than 1.5 mEq/L). It may be caused by various factors such as malnutrition, diarrhea, diuretics, or alcohol abuse. It may cause symptoms such as muscle weakness, tremors, tetany, or cardiac arrhythmias.

Choice B Reason: This choice is correct because hyperkalemia is a common finding in the oliguric phase of acute kidney injury. Hyperkalemia is a condition in which the serum potassium level is higher than normal (more than 5 mEq/L). It may be caused by reduced renal excretion of potassium due to decreased urine output (oliguria). It may cause symptoms such as muscle weakness, paresthesia, bradycardia, or cardiac arrest.

Choice C Reason: This choice is incorrect because decreased creatinine level is not a common finding in the oliguric phase of acute kidney injury. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in urine. A normal creatinine level ranges from 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women. In acute kidney injury, creatinine level usually increases due to reduced renal function and impaired clearance of creatinine.

Choice D Reason: This choice is incorrect because increased glomerular filtration rate (GFR) is not a common finding in the oliguric phase of acute kidney injury. GFR is a measure of how well

the kidneys filter blood and remove waste products.

A normal GFR range is 90,to 120 mL/min/1.73 m2. In acute kidney injury, GFR usually decreases due to reduced blood ﬂow,to,the kidneys or damage to the glomeruli, which are the tiny blood vessels that filter blood in the kidneys.

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A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer an osmotic diuretic IV to a client with increased intracranial pressure. Which of the following should the nurse identify as the purpose of the medication?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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