A nurse is reviewing the laboratory report of an older adult client who has primary aldosteronism and reports needing to urinate three to four times during the night. Which of the following electrolyte imbalances should the nurse expect?

Decreased magnesium level

Decreased total calcium level

Elevated phosphate level

Elevated sodium level

Answer and Explanation

The Correct Answer is D

A) Decreased magnesium level: Primary aldosteronism typically affects sodium and potassium balance, but it is less likely to cause significant changes in magnesium levels. Therefore, a decreased magnesium level is not the expected electrolyte imbalance in this condition.

B) Decreased total calcium level: Primary aldosteronism does not primarily affect calcium metabolism. While calcium levels could be influenced indirectly, they are not a primary concern in this disorder. Hence, a decreased total calcium level is not expected.

C) Elevated phosphate level: Phosphate levels are generally not directly influenced by aldosterone. Elevated phosphate levels might be seen in other conditions, but they are not characteristic of primary aldosteronism.

D) Elevated sodium level: Primary aldosteronism leads to excess production of aldosterone, which promotes sodium retention by the kidneys. This retention causes elevated sodium levels, resulting in hypernatremia, and contributes to symptoms like frequent urination due to the body's attempt to excrete excess sodium through increased urine production.

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Correct Answer is D

Explanation

A) "I will remain in the hospital until my treatment is completed.": Hospitalization is not typically required for the entire duration of tuberculosis (TB) treatment. Most patients with TB can continue their treatment at home with proper medication and infection control measures, unless they have severe disease or complications.

B) "I will wear a surgical mask around my family.": A surgical mask is not sufficient to protect others from TB. Patients with active TB should wear an N95 respirator mask to reduce the risk of spreading the infection, especially in situations where close contact is unavoidable.

C) "I will need medication to treat my condition for the rest of my life.": TB treatment generally involves a course of medication lasting 6 to 9 months. Long-term, lifelong medication is not required; however, adherence to the full course of prescribed antibiotics is crucial to ensure the infection is fully eradicated.

D) "I will need to provide a sputum specimen every 4 weeks until I test negative.": Monitoring sputum samples every 4 weeks is a standard practice to assess the effectiveness of TB treatment and confirm that the patient is no longer infectious. This statement indicates an understanding of the ongoing evaluation needed during treatment.

A. Bicarbonate 26 mEq/L B. Serum pH 7.32 C. Creatinine 1.2 mg/dL D. BUN 20 mg/dL

Correct Answer is B

Explanation

A) Bicarbonate 26 mEq/L: A bicarbonate level of 26 mEq/L is within the normal range (22-28 mEq/L) and does not indicate metabolic acidosis, which is characteristic of diabetic ketoacidosis (DKA). In DKA, bicarbonate levels are usually decreased due to buffering of the excess acids.

B) Serum pH 7.32: A serum pH of 7.32 is indicative of acidemia, which is consistent with metabolic acidosis seen in DKA. The pH is typically lower than the normal range (7.35-7.45) in DKA due to the accumulation of ketoacids.

C) Creatinine 1.2 mg/dL: A creatinine level of 1.2 mg/dL is slightly elevated but does not specifically indicate metabolic acidosis. Elevated creatinine may suggest renal impairment but is not directly linked to the acid-base disturbance seen in DKA.

D) BUN 20 mg/dL: A blood urea nitrogen (BUN) level of 20 mg/dL is elevated and may indicate dehydration or kidney dysfunction but does not specifically diagnose the acid-base imbalance associated with DKA. In DKA, bicarbonate and pH levels are more directly affected.

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A nurse is reviewing the laboratory report of an older adult client who has primary aldosteronism and reports needing to urinate three to four times during the night. Which of the following electrolyte imbalances should the nurse expect?

Nursing Test Bank

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