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 C

Explanation

Choice A reason: This is incorrect because 0.9% sodium chloride (normal saline) is an isotonic solution, not a hypotonic one. Isotonic solutions have the same concentration of solutes as blood plasma and do not cause fluid movement across the cell membrane.

Choice B reason:

This is incorrect because 0.9% sodium chloride (normal saline) is an isotonic solution, not a hypertonic one. Hypertonic solutions have a higher concentration of solutes than blood plasma and cause fluid to move out of the cells and into the vascular space.

Choice C reason:

This is correct because 0.9% sodium chloride (normal saline) is an isotonic solution that will expand the vascular space by adding fluid without changing the concentration of solutes. This is useful for patients with hyponatremia (low sodium level in the blood) who need to restore their fluid and electrolyte balance.

Choice D reason:

This is incorrect because 0.9% sodium chloride (normal saline) is an isotonic solution that will expand the vascular space by adding fluid without changing the concentration of solutes. It will not have no effect on fluid movement, as it will increase the intravascular volume.

A. Cheese. B. Broccoli. C. Almonds. D. Bananas. E. Sardines.

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

Explanation

Choice A reason:

Cheese is a good source of calcium, which is essential for bone health and muscle contraction. Calcium also helps regulate the heart rhythm and blood clotting. Cheese can provide about 200 mg of calcium per ounce.

Choice B reason:

Broccoli is a cruciferous vegetable that contains goitrogens, which are substances that can interfere with thyroid hormone synthesis and cause or worsen hypothyroidism. Hypothyroidism can lead to low levels of parathyroid hormone (PTH), which is responsible for maintaining calcium balance in the body. Therefore, broccoli should be avoided or limited by clients who have hypocalcemia due to hypoparathyroidism.

Choice C reason:

Almonds are rich in magnesium, which is a mineral that helps regulate calcium absorption and metabolism. Magnesium also plays a role in nerve and muscle function, blood pressure, and blood sugar control. Almonds can provide about 80 mg of magnesium per ounce.

Choice D reason:

Bananas are high in potassium, which is a mineral that can affect the balance of calcium in the body. High levels of potassium can cause hyperkalemia, which can lower the serum calcium level by increasing the renal excretion of calcium and decreasing the release of PTH. Therefore, bananas should be avoided or limited by clients who have hypocalcemia due to hypoparathyroidism.

Choice E reason:

Sardines are a type of oily fish that contain vitamin D, which is a fat-soluble vitamin that helps increase the intestinal absorption of calcium and phosphorus. Vitamin D also works with PTH to regulate the bone resorption and formation of calcium. Sardines can provide about 250 IU of vitamin D per 3 ounces.

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Naxlex Comprehensive Predictor Exams

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:

Correct Answer is C

Explanation

A nurse is providing dietary teaching to a client who has hypocalcemia due to hypoparathyroidism. Which of the following foods should the nurse recommend? (Select all that apply.)

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

Explanation

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

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?

A nurse is reviewing the laboratory report of a client who has diabetic ketoacidosis (DKA) Which of the following findings should the nurse expect?

A nurse is planning care for a client who has hyponatremia and is receiving IV fluid therapy with 3% sodium chloride solution. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

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?

A nurse is caring for a client who has metabolic acidosis due to diabetic ketoacidosis (DKA) Which of the following manifestations should the nurse monitor?

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 planning care for a client who has overhydration and hyponatremia. Which of the following actions should the nurse include in the plan? (Select all that apply.)