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
Severe headache and photophobia are classic symptoms of meningitis, indicating inflammation of the meninges.
Choice B rationale
Chest pain and shortness of breath are more indicative of cardiovascular or respiratory issues, not meningitis.
Choice C rationale
Abdominal pain and diarrhea are gastrointestinal symptoms and are not typically associated with meningitis.
Choice D rationale
Joint pain and swelling are more indicative of rheumatologic conditions, not meningitis.

A. Post-renal acute kidney injury (AKI). B. Diabetes insipidus (DI). C. Syndrome of inappropriate antidiuretic hormone (SIADH). D. Congestive heart failure (CHF).

Correct Answer is D

Explanation

Choice A rationale
Post-renal acute kidney injury (AKI) is caused by obstruction of urine flow, leading to decreased urine output, but it does not typically cause crackles in the lungs.
Choice B rationale
Diabetes insipidus (DI) is characterized by excessive urination and thirst due to a deficiency of antidiuretic hormone (ADH), but it does not cause crackles in the lungs.
Choice C rationale
Syndrome of inappropriate antidiuretic hormone (SIADH) involves excessive release of ADH, leading to water retention and hyponatremia, but it does not cause crackles in the lungs.
Choice D rationale
Congestive heart failure (CHF) can lead to fluid accumulation in the lungs (crackles) and decreased urine output due to poor cardiac function and renal perfusion.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is A

Explanation

A nurse is caring for a client with chronic kidney disease (CKD) who has elevated intracranial pressure (ICP). While assessing the client, the nurse hears crackles in the lungs and notes a decrease in urine output.Which complication has the client likely developed?

Correct Answer is D

Explanation

A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings would indicate the need for immediate intervention?

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

A patient has been told that the recent changes in her facial features are due to a hormonal pathology called myxedema. Her nurse’s explanation will be based on understanding that myxedema is:

A nurse has identified a fluid volume deficit in the patient who has suffered prolonged vomiting and diarrhea. Which assessment data is most important in identifying that the patient may be developing prerenal acute kidney injury (AKI)?

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 pieces of information link up correctly?

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?

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?