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.

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Correct Answer is A

Explanation

Choice A rationale
Administering supplemental oxygen is the priority intervention for a client with COPD who has an oxygen saturation of 88% on room air. This low oxygen saturation indicates hypoxemia, which requires immediate correction to prevent further respiratory distress.
Choice B rationale
Encouraging the client to use an incentive spirometer is important for lung expansion and preventing atelectasis, but it is not the priority intervention in this scenario. The immediate concern is to correct the hypoxemia.
Choice C rationale
Administering a bronchodilator as prescribed is important for managing COPD symptoms, but the priority intervention is to correct the hypoxemia by administering supplemental oxygen.
Choice D rationale
Positioning the client in high Fowler’s position can help improve breathing, but the priority intervention is to correct the hypoxemia by administering supplemental oxygen.

A. Decrease coronary artery constriction by giving aspirin. B. Increase afterload for the left ventricle in order to maximize cardiac output. C. Increase preload to reduce overall cardiac workload. D. Reduce arterial inflammation by administering statins.

Correct Answer is A

Explanation

Choice A rationale
Decreasing coronary artery constriction by giving aspirin is a primary objective in managing unstable angina. Aspirin inhibits platelet aggregation, reducing the risk of clot formation and improving blood flow in the coronary arteries. This helps to alleviate chest pain and prevent myocardial infarction.
Choice B rationale
Increasing afterload for the left ventricle to maximize cardiac output is not a desirable objective in managing unstable angina. Increasing afterload would increase the workload on the heart, which is counterproductive in patients with angina. The goal is to reduce the heart’s workload and improve blood flow.
Choice C rationale
Increasing preload to reduce overall cardiac workload is not a primary objective in managing unstable angina. Increasing preload would increase the volume of blood returning to the heart, potentially worsening symptoms. The focus is on reducing myocardial oxygen demand and improving coronary perfusion.
Choice D rationale
Reducing arterial inflammation by administering statins is a long-term strategy for managing cardiovascular disease, but it is not the immediate objective in managing unstable angina.
Statins help to lower cholesterol levels and reduce inflammation, but the immediate goal in unstable angina is to relieve chest pain and prevent myocardial infarction.

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Naxlex Comprehensive Predictor Exams

A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with increased shortness of breath and a productive cough. The nurse notes the client’s oxygen saturation is 88% on room air. Which of the following interventions should the nurse implement first?

Correct Answer is A

Explanation

A nurse caring for a patient with unstable angina will most likely need to give medications to accomplish which desirable objective?

Correct Answer is A

Explanation

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 nurse is providing education to a client with newly diagnosed type 2 diabetes mellitus. Which statement by the client indicates a need for further teaching?

Which acute event is most likely to occur in a patient who has chronic atrial fibrillation?

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 client with a long history of cirrhosis has anemia, leukopenia, and thrombocytopenia. In the context of cirrhosis, these three conditions are most likely caused by:

A man, diagnosed with alcoholic liver disease and cirrhosis, presents to his healthcare provider for treatment. He is complaining of increased blood glucose, blurred vision, and cannot remember his birth date or age. The nurse notes that he has asterixis. These signs are most likely due to:

Which clinical manifestations would the nurse expect to find during their assessment of a patient with right heart failure (RHF)?