A nurse is preparing to administer oral potassium for a client who has a potassium level of 5.5 mEq/L. Which of the following actions should the nurse take first?
Repeat the potassium level.
Withhold the medication.
Monitor for paresthesia.
Administer a hypertonic solution.
The Correct Answer is B
Choice A rationale:
Repeating the potassium level is not the first action to take. The nurse already has a recent lab value.
Choice B rationale:
The nurse should withhold the medication. The normal range for potassium is 3.5-5.0 mEq/L. A level of 5.5 mEq/L is high, so giving more potassium could lead to hyperkalemia.
Choice C rationale:
Monitoring for paresthesia is important in hyperkalemia, but it is not the first action. The nurse should first prevent further increase in potassium levels.
Choice D rationale:
Administering a hypertonic solution is not relevant in this situation. It does not directly address the high potassium level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Bleeding gums is a common symptom of vitamin C deficiency, also known as scurvy.
Choice B rationale:
Impaired vision is not typically associated with vitamin C deficiency.
Choice C rationale:
A swollen tongue is not a typical symptom of vitamin C deficiency.
Choice D rationale:
Diarrhea is not a common symptom of vitamin C deficiency. In fact, high doses of vitamin C can cause diarrhea.
Correct Answer is B
Explanation
Choice A rationale:
Hyperventilation is a compensatory mechanism for metabolic acidosis, not a cause. It helps to eliminate carbon dioxide, a weak acid, to balance the pH.
Choice B rationale:
Diarrhea causes loss of bicarbonate, a base, from the body. This can lead to metabolic acidosis as there is an excess of acids.
Choice C rationale:
Salicylate intoxication can cause both respiratory alkalosis and metabolic acidosis. However, it is not the most common cause of metabolic acidosis.
Choice D rationale:
Vomiting leads to loss of gastric acid, a strong acid. This usually results in metabolic alkalosis, not acidosis.
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