A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

Hypernatremia

Hyperglycemia

Hypercalcemia

Hyperkalemia

Answer and Explanation

The Correct Answer is B

A. Hypernatremia: This condition involves elevated sodium levels, which is not directly addressed by the insulin and dextrose order.
B. Hyperglycemia: While dextrose can exacerbate hyperglycemia, the order of insulin and dextrose is not for managing hyperglycemia but for another purpose.
C. Hypercalcemia: This condition involves elevated calcium levels and is not related to the use of insulin and dextrose.
D. Hyperkalemia: The administration of regular insulin with dextrose is often used to manage hyperkalemia. Insulin helps shift potassium into cells, while dextrose prevents hypoglycemia resulting from the insulin.

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Correct Answer is ["A","C","D"]

Explanation

A. Record intake and output: This task is within the UAP's scope of practice as it involves documenting fluid balance.

B. Assess bowel sounds: This task requires clinical judgment and assessment skills and should be performed by a licensed nurse.

C. Obtain routine vital signs: This is appropriate for the UAP to perform, as it involves routine measurements that do not require clinical assessment.

D. Document the presence of edema: The UAP can document observable findings such as edema, which is within their scope of practice.

A. Flush the IV site with normal saline, then restart the IV potassium therapy B. Discontinue the IV and restart in another site C. Flush the IV site with heparin D. Stop the IV site and check for blood return

Correct Answer is B

Explanation

A. Flush the IV site with normal saline, then restart the IV potassium therapy: Flushing and restarting the infusion at the same site is not appropriate if there is redness and swelling, as these are signs of possible phlebitis or infiltration.
B. Discontinue the IV and restart in another site: This is the correct choice. Given the erythema and edema, which indicate possible complications like phlebitis or infiltration, the IV should be discontinued and restarted in a new site to prevent further complications.
C. Flush the IV site with heparin: This is not appropriate for erythema and edema and could exacerbate the problem. Heparin is used to maintain patency of IV lines, not to treat complications.
D. Stop the IV site and check for blood return: While checking for blood return is a good practice to assess for patency, the primary action should be to discontinue the IV and start a new one due to the complications at the site.

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A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse asks the unlicensed assistive personnel (UAP) to assist in determining the fluid status of a client. Which of the following actions should the nurse delegate to the UAP? (Select All That Apply)

Correct Answer is ["A","C","D"]

Explanation

A client has been receiving IV potassium therapy. Upon further assessment, the nurse notes the site has become erythematous and edematous. Which action by the nurse is most appropriate?

Correct Answer is B

Explanation

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