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Exhibits

Select the top 5 client findings that require immediate follow-up

Abdomen rigid with decreased bowel sounds

Glucose 220mg/d

No dialysis for 24 hours

Crackles throughout the lungs

WBC 17,000 mm3

Hemoglobin 10g/dL

Potassium 7mEq/L

Creatinine 3 mg/dL

Answer and Explanation

Correct Answer : A,B,D,E,G

A. Abdomen rigid with decreased bowel sounds: A rigid, tender abdomen suggests peritonitis, a life-threatening complication of peritoneal dialysis requiring immediate intervention.

B. Glucose 220 mg/Dl: Elevated glucose is concerning but not immediately life-threatening compared to the other findings.

C. No dialysis for 24 hours: Missing dialysis leads to toxin accumulation, hyperkalemia, and fluid overload, all of which can be life-threatening.

D. Crackles throughout the lungs: Fluid overload can cause pulmonary edema, leading to respiratory distress. Immediate intervention is needed to prevent respiratory failure.

E. WBC 17,000 mm³: Leukocytosis suggests infection, possibly peritonitis, which requires urgent antibiotic therapy.

F. Hemoglobin 10 g/dL: Mild anemia is expected in CKD and not an emergency.

G. Potassium 7 mEq/L: Severe hyperkalemia is a medical emergency due to the risk of life-threatening cardiac arrhythmias.

H. Creatinine 3 mg/dl: Creatinine is chronically elevated in CKD and not an acute concern.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Prepare the client for dialysis: A potassium level of 8.3 mEq/L is critically high (normal range: 3.5–5.3 mEq/L), putting the client at immediate risk for life-threatening cardiac arrhythmias (e.g., ventricular fibrillation). Emergency dialysis is needed to remove excess potassium if other interventions (e.g., insulin, calcium gluconate) fail.

B. Start an IV and run normal saline at 50mL/hour: Fluid administration alone does not lower potassium quickly enough in a life-threatening situation.

C. Repeat the electrolyte values later in the day: Delaying treatment would increase the risk of cardiac arrest.

D. Monitor urine output: Although important, monitoring alone does not treat the emergency. Clients with acute renal failure often have little to no urine output.

A. Constipation B. Negative Trousseau’s sign C. BP of 180/88 D. Numbness and tingling of the extremities

Correct Answer is D

Explanation

A. Constipation: Hypocalcemia causes diarrhea, while hypercalcemia causes constipation.

B. Negative Trousseau’s sign: A positive Trousseau’s sign (carpal spasm during BP cuff inflation) is expected with hypocalcemia.

C. BP of 180/88: Severe hypocalcemia may cause hypotension, not hypertension.

D. Numbness and tingling of the extremities: Hypocalcemia can occur after a total thyroidectomy due to accidental removal or damage to the parathyroid glands. Neuromuscular excitability, including paresthesia (numbness and tingling), tetany, and muscle spasms, are classic signs.

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Exhibits Select the top 5 client findings that require immediate follow-up

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client diagnosed with acute renal failure and has a potassium level of 8.3 mEq/L. What collaborative intervention would be a priority for this client?

Correct Answer is A

Explanation

A nurse is caring for a client who had a total thyroidectomy and a low serum calcium level of 7.4 mg/dL. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

The nurse is looking at a set of ABG's and notices a bicarbonate level of 30. What other change would the nurse expect to see in their lab values?

What type of electrolyte imbalance would most likely occur following the administration of three tap water enemas?

The client is vomiting and very dehydrated. Which medication would be most effective in treating the nausea and vomiting?

The client's potassium level is 2.2 What nursing action has the highest priority?

The new post op client in PACU suddenly develops a temperature of 103 degrees F. What would you suspect?

A client is in a motor vehicle accident with severe thoracic trauma. Which acid-base imbalance is most likely to develop?

The nurse is looking at a set of ABG's and notices a bicarbonate level of 30. What other change would the nurse expect to see in their lab values?

A nurse is assessing a client who is 2 weeks postoperative following a kidney transplant. Which of the following manifestations should the nurse identify as possible organ rejection?

Exhibits

Select the top 5 client findings that require immediate follow-up