Exhibits
The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

Cerebral edema

Septic shock

Cardiac arrhythmias

Renal failure

Hypotension

Respiratory alkalosis

Answer and Explanation

Correct Answer : A,C,D,E

A. This is a serious complication in DKA, particularly in children, where the shift in osmolality during treatment can lead to fluid shifts into the brain. It can present with neurological deterioration, headache, altered mental status, and even coma.
B.   Septic shock
While infection can precipitate DKA, septic shock itself is not a direct complication of DKA. However, DKA can predispose patients to infections due to impaired immune function, dehydration, and hyperglycemia.
C.   Cardiac arrhythmias
Electrolyte imbalances, particularly hypokalemia or hyperkalemia (depending on treatment phase), can predispose individuals with DKA to cardiac arrhythmias such as ventricular arrhythmias (e.g., ventricular tachycardia) or atrial fibrillation.
D.   Renal failure
Acute kidney injury (AKI) can occur due to dehydration, electrolyte imbalances, and the direct effects of acidosis. However, with prompt and appropriate treatment, renal function typically recovers.
E.   Hypotension
Dehydration and volume depletion are common in DKA due to osmotic diuresis and fluid loss. This can lead to hypovolemic shock and hypotension if not adequately managed with fluid resuscitation.
F Respiratory alkalosis
DKA is associated with metabolic acidosis, not respiratory alkalosis. The body compensates for acidosis by increasing respiratory rate (Kussmaul respirations) to blow off CO2 and normalize pH, but this does not lead to respiratory alkalosis.

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Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"C"}}

Explanation

Metoprolol 5 mg every 2 to 3 min up to three doses

Nonessential: Metoprolol is a beta-blocker used to reduce heart rate and blood pressure. However, in this scenario, the client already has a history of irregular heart rate and is currently tachycardic. Starting metoprolol at this frequency and dose without knowing the client's response or stability could exacerbate their condition. Therefore, it is considered nonessential until further assessment and stabilization.

Oxygen at 2 L/min via nasal cannula

Anticipated: The client's oxygen saturation dropped to 89% at 1015 and improved to 92% with oxygen supplementation by 1200. Given the client's symptoms and fluctuating oxygen saturation, supplemental oxygen is necessary to ensure adequate tissue oxygenation and is anticipated to support respiratory function.

Draw electrolytes along with Hgb and Hct

Nonessential: While electrolyte levels (such as potassium) are important to monitor, they are not immediately critical in the management of acute myocardial infarction or unstable angina. They can be drawn later for comprehensive assessment but are not urgently needed in the acute phase of care.

Morphine 6 mg IV bolus every 3 hr as needed for pain

Anticipated: Morphine is indicated for managing severe pain, such as chest pain associated with myocardial infarction. The client reported significant chest pain (7/10 initially), and morphine is appropriate to alleviate discomfort and reduce myocardial oxygen demand.

Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses

Anticipated: Nitroglycerin is a vasodilator that helps relieve chest pain associated with angina or myocardial infarction by dilating coronary arteries. Given the client's chest pain and the protocol for administering nitroglycerin, it is anticipated to be effective in managing symptoms and improving coronary blood flow.

Obtain daily weight

Nonessential: Daily weight monitoring is useful for assessing fluid status in some conditions, but it is not immediately necessary in the acute management of myocardial infarction or unstable angina unless there are signs of fluid overload or heart failure, which are not evident in this case.

Atropine 0.5 mg IV bolus every 5 min up to 2 mg

Contraindicated: Atropine is used to treat bradycardia (slow heart rate). However, the client in this scenario is tachycardic (rapid heart rate), and atropine would exacerbate this condition. Therefore, it is contraindicated and should not be administered.

A. "Twist at the waist when standing from a seated position." B. "Move your stronger leg first when using a walker." C. "Use a raised toilet seat to maintain your hips above your knees." D. "Apply a heating pad to the operative hip to decrease pain."

Correct Answer is C

Explanation

C. Using a raised toilet seat helps maintain the hips above the knees, which is recommended after THA to reduce strain on the hip joint and facilitate safer toileting. Keeping the hips higher than the knees helps prevent excessive flexion of the hip joint, which can strain the surgical site.

A Twisting at the waist places stress on the hip joint and can increase the risk of dislocation, which is a significant concern after THA surgery.

B. This option does not specify the correct procedure for using a walker

D. Heat application, such as using a heating pad, is not recommended for the operative hip after THA. Heat can increase blood flow and inflammation, potentially worsening pain and swelling.

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ExhibitsThe nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Exhibits For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"C"}}

Explanation

Metoprolol 5 mg every 2 to 3 min up to three doses

Oxygen at 2 L/min via nasal cannula

Draw electrolytes along with Hgb and Hct

Morphine 6 mg IV bolus every 3 hr as needed for pain

Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses

Obtain daily weight

Atropine 0.5 mg IV bolus every 5 min up to 2 mg

A nurse is providing discharge teaching to a client who is postoperative following a total hip arthroplasty. Which of the following statements should the nurse make?

Correct Answer is C

Explanation

A nurse is caring for a client who has oral achalasia. The nurse should ask the client which of the following questions to assess their ability to swallow?

A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching?

A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following should the nurse identify as a contributing factor to the client's manifestations?

A nurse is providing teaching to a client who is to start furosemide therapy for heart failure. Which of the following statements indicates that the client understands a potential adverse effect of this medication?

A nurse is providing discharge teaching for a client who is receiving treatment for genital herpes. Which of the following statements by the client indicates effectiveness of the teaching?

A nurse is providing teaching about client rights to a client who has a brain tumor. Which of the following client statements indicates an understanding of the teaching?

A nurse is administering furosemide 80 mg PO twice daily to a client who has pulmonary edema. Which of the following assessment findings indicates to the nurse that the medication is effective?

A nurse is caring for a client who has a sealed radiation implant. Which of the following actions should the nurse take?

Exhibits
The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.