The charge nurse has stated a client has hyperkalemia and needs cardiac monitoring. The nurse noted which of following lab values?
Sodium 148
Potassium 3.1
Sodium 130
Potassium 5.7
The Correct Answer is D
A. Sodium 148: This represents mild hypernatremia, but sodium levels are not the primary concern for cardiac monitoring.
B. Potassium 3.1: This is hypokalemia (low potassium), not hyperkalemia.
C. Sodium 130: This represents hyponatremia, which can cause neurological symptoms, not hyperkalemia.
D. Potassium 5.7: Hyperkalemia is defined as K⁺ >5.0 mEq/L. Levels above 5.5 can cause dangerous cardiac dysrhythmias, requiring ECG monitoring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. NG: Stands for nasogastric, referring to a tube inserted through the nose into the stomach.
B. T: Not a standard abbreviation for medication administration.
C. DNR: Stands for "Do Not Resuscitate," unrelated to medication timing.
D. AC: "AC" is the standard medical abbreviation for "before meals" (Latin: ante cibum).
Correct Answer is D
Explanation
A. "The list obtained from the client does not need to list medications that are not prescribed by the client's provider." All medications must be documented, including over-the-counter drugs, herbal supplements, and non-prescribed medications to avoid drug interactions.
B. "A nurse should write a verbal order in the medical record for medications the client was taking at home." Verbal orders should be avoided unless in an emergency, and reconciliation should be based on a review of documented prescriptions and client reports rather than nurse-written orders.
C. "Complete the reconciliation process one time only when the client is first admitted to the hospital." Medication reconciliation must be repeated at every transition of care, including admission, transfer between units, and discharge.
D. "A comprehensive list of medications is reviewed upon admission/transfer and provided for the client at the time of discharge." Medication reconciliation is a critical process to ensure continuity of care and prevent medication errors. It must be conducted at every transition of care (admission, transfer, and discharge) to compare the client’s home medications with hospital prescriptions and make adjustments as needed.
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