A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremors, muscle cramps, and nausea.
What does the nurse suspect?
Hypokalemia.
Renal failure.
Hyperkalemia.
Heart failure.
The Correct Answer is A
Hypokalemia is a condition of low potassium levels in the blood, which can be caused by diuretics such as furosemide (Lasix) that increase the excretion of potassium in the urine. Potassium is an important electrolyte that helps regulate the function of nerves and muscles, including the heart. Low potassium levels can cause symptoms such as confusion, tremors, muscle cramps, and nausea, which are consistent with the patient’s presentation.
Choice B, renal failure, is wrong because furosemide is used to treat fluid retention and edema caused by kidney disease, not to cause it. Renal failure would also cause symptoms such as decreased urine output, swelling, fatigue, and shortness of breath, which are not mentioned in the question.
Choice C, hyperkalemia, is wrong because hyperkalemia is a condition of high potassium levels in the blood, which can be caused by kidney disease or certain medications that decrease the excretion of potassium in the urine. Hyperkalemia can cause symptoms such as weakness, irregular heartbeat, paralysis, and chest pain, which are different from the patient’s symptoms.
Choice D, heart failure, is wrong because furosemide is also used to treat fluid retention and edema caused by heart failure, not to cause it. Heart failure would also cause symptoms such as shortness of breath, coughing, fatigue, and rapid weight gain, which are not mentioned in the question.
Normal ranges for potassium levels in the blood are 3.5 to 5.0 milliequivalents per liter (mEq/L) for adults and 3.4 to 4.7 mEq/L for children.
A level below 3.5 mEq/L is considered hypokalemic and a level above 5.0 mEq/L is considered hyperkalemic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
PT stands for prothrombin time, which is a measure of how long it takes the blood to clot.
INR stands for international normalized ratio, which is a way of standardizing the PT results across different laboratories.
Warfarin is a blood thinner that works by inhibiting the production of vitamin K-dependent clotting factors in the liver.
Therefore, warfarin prolongs the PT and increases the INR.The PT/INR test is used to monitor the effectiveness of warfarin therapy and adjust the dose accordingly.
Choice A is wrong because PTT stands for partial thromboplastin time, which is another measure of blood clotting time, but it reflects the activity of different clotting factors than PT.PTT is used to monitor heparin therapy, not warfarin therapy.
Choice C is wrong because aPTT stands for activated partial thromboplastin time, which is a variation of PTT that uses an activator to speed up the clotting time.Like PTT, aPTT is used to monitor heparin therapy, not warfarin therapy.
Choice D is wrong because ACT stands for activated clotting time, which is a measure of the whole blood clotting time.ACT is used to monitor high-dose heparin therapy during certain procedures, such as cardiac bypass surgery or angioplasty.
The normal ranges for these tests may vary depending on the laboratory and the method used, but generally, they are:
• PT: 10 to 13 seconds
• INR: 0.8 to 1.2 (without warfarin) or 2.0 to 3.0 (with warfarin)
• PTT: 25 to 35 seconds
• aPTT: 30 to 40 seconds
• ACT: 70 to 120 seconds
Correct Answer is C
Explanation
LDL cholesterol is sometimes called “bad” cholesterol because it can build up on the walls of the blood vessels and cause health problems, such as heart disease and stroke.High levels of LDL cholesterol raise your risk for cardiovascular disease. Therefore, decreasing LDL cholesterol levels can lower your risk and improve your health.
Choice A is wrong because increasing LDL cholesterol levels would have the opposite effect of decreasing them.It would increase your risk for cardiovascular disease and plaque buildup in your arteries.
Choice B is wrong because increasing HDL cholesterol levels is not enough to decrease the risk of cardiovascular disease.HDL cholesterol is sometimes called “good” cholesterol because it can move LDL cholesterol from the blood to the liver, where it is broken down and removed from the body.
However, HDL cholesterol levels alone are not a good indicator of your cardiovascular health.You also need to consider your total cholesterol, LDL cholesterol and triglyceride levels.
Choice D is wrong because decreasing HDL cholesterol levels would also increase your risk for cardiovascular disease.HDL cholesterol helps to lower LDL cholesterol levels and protect your blood vessels from plaque buildup.
Therefore, decreasing HDL cholesterol levels would reduce this protective effect and make you more vulnerable to heart disease and stroke.
The ideal ranges for cholesterol levels are as follows:
• Total cholesterol: below 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: above 40 mg/dL for men and above 50 mg/dL for women
You can lower your LDL cholesterol levels and increase your HDL cholesterol levels by making healthy lifestyle changes, such as eating a balanced diet, exercising regularly, quitting smoking, managing stress and taking medication if prescribed by your doctor.
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