An elderly patient has been having copious vomiting for several days and has become lethargic and weak. His mucous membranes are dry.

He has poor skin turgor.

Lab work shows: sodium of 145, ABGs: pH 7.58, PCO2 38, HCO3 38, PO2 95, SO2 98. Which response best explains the patient’s lethargy and weakness?

The hypokalemia brought on severe muscle spasms, causing exhaustion.

Due to his low potassium, his cells rely on glycolysis.

Due to the hypokalemia, his cells are hyperpolarized.

The hypernatremia caused cellular dehydration, leading to lethargy.

Answer and Explanation

The Correct Answer is D

Choice A rationale
Hypokalemia can cause muscle weakness and cramps, but it does not typically lead to severe muscle spasms causing exhaustion. The patient’s symptoms of lethargy and weakness are more likely related to electrolyte imbalances and dehydration rather than muscle spasms.
Choice B rationale
While low potassium levels can affect cellular metabolism, the primary issue here is not glycolysis. The patient’s symptoms are more consistent with dehydration and electrolyte imbalances rather than a metabolic shift to glycolysis.
Choice C rationale
Hypokalemia can cause cells to become hyperpolarized, leading to muscle weakness and decreased reflexes. However, the patient’s symptoms of lethargy and weakness are more likely due to dehydration and electrolyte imbalances rather than cellular hyperpolarization.
Choice D rationale
Hypernatremia, or high sodium levels, can cause cellular dehydration, leading to symptoms such as lethargy and weakness. The patient’s lab results and clinical presentation are consistent with hypernatremia-induced cellular dehydration, which explains his symptoms.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A rationale
Deep vein thrombosis (DVT) can lead to pulmonary embolism but does not directly cause chest pain and shortness of breath.
Choice B rationale
Pulmonary embolus (PE) is characterized by chest pain, shortness of breath, and hemoptysis (coughing up blood), especially in patients on bed rest.
Choice C rationale
Anemia can cause fatigue and shortness of breath but not typically chest pain and hemoptysis.
Choice D rationale
Right heart failure can cause shortness of breath and edema but not typically chest pain and hemoptysis.

A. Wearing an N95 mask while in the room of a patient with airborne precautions. B. Wearing a facemask while in the room of a patient with droplet precautions. C. Use of a separate disposable blood pressure cuff for any patient with a draining wound. D. Use of strict hand washing measures once in every 8-hour work shift.

Correct Answer is C

Explanation

Choice A rationale
Wearing an N95 mask is appropriate for airborne precautions, such as tuberculosis, but not specifically for MRSA, which requires contact precautions.

Choice B rationale
Wearing a facemask is suitable for droplet precautions, such as influenza, but MRSA is primarily spread through direct contact, not droplets.
Choice C rationale
Using a separate disposable blood pressure cuff for patients with draining wounds helps prevent the spread of MRSA. MRSA can be transmitted via contaminated medical equipment.
Choice D rationale
Strict hand washing measures are essential but should be performed more frequently than once every 8-hour shift. Hand hygiene should be practiced before and after patient contact.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient, who is on complete bed rest following extensive surgery, begins to complain of chest pain and shortness of breath with hemoptysis. His SO2 measures 90%. The nurse recognizes that the patient is most likely exhibiting signs and symptoms of which condition?

Correct Answer is B

Explanation

Which infection control measure, by the nurse, reduces the potential spread of methicillin-resistant Staphylococcus aureus (MRSA)?

Correct Answer is C

Explanation

A nurse is caring for a client with a body temperature of 38°C (100.4°F). Which of the following interventions should the nurse prioritize?

What is the significance of elevated serum levels of troponin?

A nurse is caring for a client with congestive heart failure (CHF). Which of the following symptoms would indicate worsening of the condition?

A nurse is caring for a client with a temperature of 37.5°C (99.5°F) and a respiratory rate of 28 breaths per minute. Which condition is the client most likely experiencing?

A client with a history of hypertension is admitted with a severe headache and blurred vision. Which of the following findings would indicate a hypertensive crisis?

A registered nurse (RN) is providing strategies for “better breathing” to a patient with emphysema. Successful teaching of this topic would be identified when the patient states that he will:

A nurse is assessing a client with suspected meningitis. Which of the following symptoms would most likely indicate meningitis?

A nurse is assessing a client with a temperature of 38°C (100.4°F) and notes a red, swollen area on the client’s leg. Which condition is the client most likely experiencing?