An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Hyperkalemia

Hyponatremia

Fluid volume excess

Hypernatremia

Answer and Explanation

The Correct Answer is B

Choice A: Hyperkalemia is not an imbalance that this patient is demonstrating, because this condition occurs when the blood potassium level is too high. This can happen in patients who have renal failure, acidosis, or excessive potassium intake. Hyperkalemia can cause muscle weakness, cardiac arrhythmias, and paralysis.

Choice B: Hyponatremia is an imbalance that this patient is demonstrating, because this condition occurs when the blood sodium level is too low. This can happen in patients who have watery diarrhea, which causes the loss of sodium and water from the body. Hyponatremia can cause abdominal and muscle cramping, nausea, confusion, and seizures.

Choice C: Fluid volume excess is not an imbalance that this patient is demonstrating, because this condition occurs when the body retains more ﬂuid than it excretes. This can happen in patients who have heart failure, kidney failure, or excessive ﬂuid intake. Fluid volume excess can cause edema, distended neck veins, and crackles in the lungs.

Choice D: Hypernatremia is not an imbalance that this patient is demonstrating, because this condition occurs when the blood sodium level is too high. This can happen in patients who have dehydration, diabetes insipidus, or excessive sodium intake. Hypernatremia can cause thirst, dry mucous membranes, agitation, and coma.

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Correct Answer is B

Explanation

Choice A: A client who is taking a thiazide diuretic is not at risk for metabolic acidosis, but rather for metabolic alkalosis. This is a condition that occurs when the body has too much bicarbonate or loses too much acid. This can happen in patients who take thiazide diuretics, which increase the excretion of sodium, chloride, and water, but also cause the retention of bicarbonate.

Choice B: A client who has diarrhea is at risk for metabolic acidosis, because this condition occurs when the body produces too much acid or loses too much bicarbonate. This can happen in patients who have diarrhea, which causes the loss of intestinal ﬂuids that contain bicarbonate and other bases.

Choice C: A client who is vomiting is not at risk for metabolic acidosis, but rather for metabolic alkalosis. This is a condition that occurs when the body has too much bicarbonate or loses too much acid. This can happen in patients who have vomiting, which causes the loss of gastric ﬂuids that contain hydrochloric acid and other acids.

Choice D: A client who has salicylate intoxication is at risk for metabolic acidosis, because this condition occurs when the body produces too much acid or loses too much bicarbonate. This can happen in patients who have salicylate intoxication, which is a toxic reaction to aspirin or other salicylates. Salicylates increase the production of organic acids and interfere with the renal excretion of acids.

A. Calcium-containing antacids B. Increased vitamin D intake C. Potassium phosphate D. Additional milk intake E. IV normal saline

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

Explanation

Choice A: Calcium-containing antacids are prescribed for patients with high serum phosphate levels, because calcium binds with phosphate and lowers its concentration in the blood. Calcium-containing antacids also help to prevent or treat hypocalcemia, which is a common complication of hyperphosphatemia.

Choice B: Increased vitamin D intake is not prescribed for patients with high serum phosphate levels, because vitamin D enhances the absorption of both calcium and phosphate from the intestines. Increased vitamin D intake can worsen hyperphosphatemia and hypocalcemia.

Choice C: Potassium phosphate is not prescribed for patients with high serum phosphate levels, because potassium phosphate is a source of phosphate that increases its concentration in the blood. Potassium phosphate can also cause hyperkalemia, which is a dangerous condition that aﬀects the heart rhythm.

Choice D: Additional milk intake is not prescribed for patients with high serum phosphate levels, because milk is rich in both calcium and phosphate. Additional milk intake can worsen hyperphosphatemia and hypocalcemia.

Choice E: IV normal saline is prescribed for patients with high serum phosphate levels, because normal saline helps to dilute the blood and lower the concentration of phosphate. Normal saline also helps to maintain ﬂuid and electrolyte balance in the body.

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An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is B

Explanation

A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.

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

Explanation

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