The nurse is caring for a patient who has been vomiting and has diarrhea for 3 days and now has muscle weakness and paresthesias in his hands and feet, along with an irregular pulse rate and rhythm, and shallow respirations with crackles on auscultation of his lungs bilaterally. The nurse suspects that these symptoms are most likely due to which electrolyte imbalance?

Hypercalcemia.

Hypokalemia.

Hypermagnesemia.

Hypophosphatemia.

Answer and Explanation

The Correct Answer is B

Choice A: Hypercalcemia. This is a condition of having too much calcium in the blood. It can cause muscle weakness, constipation, nausea, vomiting, confusion, and irregular heartbeat. However, it does not typically cause paresthesias (tingling or numbness), diarrhea, or crackles in the lungs.

Choice B:

Hypokalemia. This is a condition of having too low potassium in the blood. It can cause muscle weakness, paresthesias, irregular heartbeat, shallow respirations, and increased risk of digoxin toxicity (a medication used to treat heart failure) It can also cause vomiting and diarrhea, which can worsen the potassium loss. This choice matches the symptoms of the patient.

Choice C:

Hypermagnesemia. This is a condition of having too much magnesium in the blood. It can cause muscle weakness, nausea, vomiting, low blood pressure, bradycardia (slow heart rate), and respiratory depression. However, it does not usually cause paresthesias, diarrhea, or crackles in the lungs.

Choice D:

Hypophosphatemia. This is a condition of having too low phosphate in the blood. It can cause muscle weakness, bone pain, rickets (softening of bones), and impaired cellular function. However, it does not typically cause paresthesias, irregular heartbeat, shallow respirations, or crackles in the lungs.

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Correct Answer is D

Explanation

Choice A reason: Shaving the hair around the insertion site is not recommended because it can cause skin irritation and increase the risk of infection.

Choice B reason:

Obtaining informed consent from the patient is important, but it is not a step that the nurse should perform before inserting the catheter. Informed consent should be obtained by the physician or advanced practice nurse who will perform the procedure.

Choice C reason:

Administering prophylactic antibiotics to the patient is not a routine practice for central venous catheter insertion. Antibiotics may be indicated for patients with certain risk factors, such as immunosuppression, but they should be prescribed by the physician or advanced practice nurse.

Choice D reason:

Placing the patient in Trendelenburg position is an important step that the nurse should perform before inserting the catheter. This position helps to distend the jugular vein and reduce the risk of air embolism during catheter insertion.

A. Jugular vein distension. B. Weight gain of 2 kg in one day. C. Decreased hematocrit. D. Bounding pulse. E. Flat neck veins.

Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason:

Jugular vein distension is a sign of fluid overload because it indicates increased pressure in the right atrium and superior vena cava due to excess blood volume.

Choice B reason:

Weight gain of 2 kg in one day is a sign of fluid overload because it reflects fluid retention in the body. A weight gain of 1 kg (2.2 lb) is equivalent to 1 L of fluid.

Choice C reason:

Decreased hematocrit is a sign of fluid overload because it indicates hemodilution or dilution of the blood due to excess fluid in the intravascular space.

Choice D reason:

Bounding pulse is a sign of fluid overload because it reflects increased cardiac output and stroke volume due to excess blood volume.

Choice E reason:

Flat neck veins are not a sign of fluid overload, but rather a sign of fluid deficit or dehydration. In fluid overload, neck veins will be distended or elevated.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing to insert a central venous catheter into a patient's right internal jugular vein using ultrasound guidance. What is an important step that the nurse should perform before inserting the catheter?

Correct Answer is D

Explanation

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse report to the provider? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

The nurse is caring for a patient with severe burns who is receiving IV fluid resuscitation with lactated Ringer's solution. The nurse understands that this type of solution is used for this patient because it:

A nurse is caring for a client who has metabolic acidosis and is receiving sodium bicarbonate IV bolus and infusion to correct the pH imbalance. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

The nurse is preparing to hang a bag of 0.9% sodium chloride (normal saline) for a patient who has hyponatremia. The nurse knows that this type of solution is:

A nurse is providing discharge instructions to a client who has chronic heart failure and is prescribed furosemide, a loop diuretic. Which of the following dietary modifications should the nurse include in the teaching? (Select all that apply.)

A nurse is reviewing the laboratory results of a client who has chronic kidney disease and notes that the serum phosphate level is elevated. The nurse should anticipate that which of the following electrolyte levels will be decreased?

A nurse is administering albumin to a client who has hypovolemic shock due to hemorrhage. The nurse understands that albumin is which of the following types of solutions?

A nurse is reviewing laboratory results for a client who has hypokalemia. Which of the following findings should the nurse expect?

A patient has been admitted with a potassium level of 6.8 mEq/L. The nurse would expect which of the following electrocardiogram (ECG) changes as a result of this laboratory value?