After receiving change-of-shift report, which client should the nurse assess first?

Client with serum phosphorus level of 4.5 mg/dL.

Client with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes.

Client with serum potassium level of 5.0 mEq/L who is complaining of abdominal cramping.

Client with serum sodium level of 145 mEq/L who has a dry mouth and is asking for a glass of water.

Answer and Explanation

The Correct Answer is B

A. Client with serum phosphorus level of 4.5 mg/dL: This is within the normal range for phosphorus (2.5-4.5 mg/dL), and the client does not require immediate assessment.

B. Client with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes: This is the correct answer. A magnesium level of 1.1 mEq/L is below the normal range (1.5-2.5 mEq/L), and symptoms like tremors and hyperactive reflexes indicate hypomagnesemia, which can lead to serious complications such as arrhythmias.

C. Client with serum potassium level of 5.0 mEq/L who is complaining of abdominal cramping: A potassium level of 5.0 mEq/L is within the normal range (3.5-5.0 mEq/L), so this client does not need immediate intervention.

D. Client with serum sodium level of 145 mEq/L who has a dry mouth and is asking for a glass of water: A sodium level of 145 mEq/L is at the upper end of normal (135-145 mEq/L), and the symptoms are likely due to dehydration or a normal response.

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Correct Answer is ["A","B","E"]

Explanation

A. LDL of 160 mg/dL is elevated, which is a risk factor for atherosclerosis.

B. Total cholesterol of 280 mg/dL is above the recommended level, increasing the risk of atherosclerosis.

C. Serum albumin is within the normal range and does not indicate atherosclerosis risk.

D. HDL cholesterol at 50 mg/dL is considered within a normal protective range and is not indicative of atherosclerosis risk.

E. Triglycerides of 200 mg/dL are also elevated, contributing to the risk for atherosclerosis.

A. Tell the student to stop playing immediately if any dyspnea occurs. B. Refer the student to a cardiologist for further diagnostic testing. C. Allow the student to participate on the soccer team. D. Obtain more detailed information about the student's family health history.

Correct Answer is C

Explanation

A. It is appropriate to monitor for symptoms of bradycardia, but the student is currently asymptomatic.

B. Referral to a cardiologist is not necessary unless the student develops symptoms or other concerning signs.

C. Sinus bradycardia can be normal in young, healthy athletes, especially those who engage in regular physical activity. Since the student is asymptomatic, with no signs of dyspnea, chest pain, or other concerning symptoms, there is no reason to restrict participation in sports.

D. Family history may be helpful, but this is not the immediate priority when the student is asymptomatic.

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After receiving change-of-shift report, which client should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse reviews a client's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. The students blood pressure is 119/76 and denies any health issues. Which action by the nurse is most appropriate?

Correct Answer is C

Explanation

After the nurse has taught the client with a newly diagnosed sexually transmitted infection about expedited partner therapy, which client statement indicates that teaching has been effective?

A nurse leaves a coffee shop and sees a man lying on the ground. He is unresponsive and has no pulse and the nurse begins chest compressions. EMS arrives and connects the cardiac monitor displaying this rhythm. Identify the rhythm.

A client has just experienced a 90-second tonic-clonic seizure and has the following arterial blood gas results: pH 7.12, HCO3 22 mEq/L, PaCO2 55 mmHg, PaO2 60 mmHg. Which intervention is the most appropriate?

A nurse is reviewing the chart of a new client in the family medicine clinic and notes that the client is identified as "George Smith." The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?

The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding?

The healthcare provider orders dobutamine at 12 mcg/kg/min. The client weighs 75 kg. The pharmacy provides 250 mL of D5W with 1 g of dobutamine. How many mL/hr should the IV pump be programmed for? (Round to a whole number.)

A client who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine levels. Which prescribed therapy should the nurse implement first?