The nurse is reviewing recent serum lab results for a postoperative male client who underwent a thyroidectomy two days ago. The client is complaining of new onset abdominal cramping and diarrhea and has developed an irregular heart rate. Which emergency medication should the nurse expect to administer to this client?

Furosemide (Lasix)

Diazepam (Valium)

Calcium gluconate

Calcitonin

Answer and Explanation

The Correct Answer is C

A. Furosemide (Lasix): This is a diuretic used to treat fluid retention and does not address the symptoms related to calcium imbalances.
B. Diazepam (Valium): This is an anxiolytic and does not address the symptoms associated with hypocalcemia following a thyroidectomy.
C. Calcium gluconate: This is the appropriate medication for treating hypocalcemia, which can occur after a thyroidectomy due to potential damage to or removal of parathyroid glands, leading to symptoms such as abdominal cramping and irregular heart rate.
D. Calcitonin: While this hormone helps regulate calcium levels, it is more commonly used to treat hypercalcemia, not hypocalcemia.

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Correct Answer is A

Explanation

A. Hypocalcemia: Hypocalcemia can cause signs such as muscle twitching, spasms, or tetany, which could be observed in the upper extremity and might be noted during a blood pressure measurement.
B. Hypokalemia: While hypokalemia can cause muscle weakness and cramping, it is less directly associated with specific upper extremity signs compared to hypocalcemia.
C. Hypophosphatemia: This generally affects energy levels and muscle function but is less commonly associated with immediate and visible upper extremity signs.
D. Hyponatremia: This primarily affects fluid balance and mental status, and is less likely to present with specific upper extremity findings during a blood pressure check.

A. Kidney conservation of bicarbonate and excretion of hydrogen ions B. Deep, rapid respirations to increase CO2 excretion C. Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate D. Shifting of bicarbonate into cells in exchange for chloride

Correct Answer is C

Explanation

A. Kidney conservation of bicarbonate and excretion of hydrogen ions: This option is not correct for metabolic alkalosis. In metabolic alkalosis, the kidneys would typically excrete bicarbonate rather than conserve it.
B. Deep, rapid respirations to increase CO2 excretion: This is incorrect because deep, rapid respirations are more associated with compensating for metabolic acidosis by increasing CO2 excretion. In metabolic alkalosis, the body attempts to retain CO2.
C. Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate: This is the correct choice. In metabolic alkalosis, the body compensates by reducing respiration rate (hypoventilation) to retain CO2, which helps to counteract the elevated pH. Additionally, the kidneys may excrete bicarbonate to balance the pH.
D. Shifting of bicarbonate into cells in exchange for chloride: This mechanism is more related to respiratory alkalosis rather than metabolic alkalosis. In metabolic alkalosis, the primary compensatory mechanisms involve changes in respiratory rate and renal bicarbonate excretion.

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Naxlex Comprehensive Predictor Exams

The illustration reflects a client's upper extremity while the nurse obtains a manual blood pressure. Which electrolyte abnormality is the nurse most likely to see in the client's blood chemistry results?

Correct Answer is A

Explanation

A student nurse is working with their preceptor on a medical-surgical unit. While reviewing concepts related to acid-base balance, what should the preceptor state is a compensatory mechanism for metabolic alkalosis?

Correct Answer is C

Explanation

A nurse asks the unlicensed assistive personnel (UAP) to assist in determining the fluid status of a client. Which of the following actions should the nurse delegate to the UAP? (Select All That Apply)

A client who takes furosemide (Lasix) and propranolol (Inderal) is scheduled for breast reconstruction surgery. Which additional client information requires prompt collaboration with the healthcare provider before surgery?

A nurse is caring for a client who had an abdominal hysterectomy. Which intervention best prevents postoperative thrombosis?

The client is NPO and is receiving total parenteral nutrition (TPN) via a peripherally inserted central catheter. Which precautions should the nurse implement? (Select All That Apply)

A nurse is assessing a client 12 hours following an emergency abdominal surgery. Which assessment finding requires prompt collaboration with the primary health care provider?

A client indicates to the nurse a pain level of 8 out of 10. The nurse notes the client has an order for morphine 4 mg IV Q 6 hr PRN for moderate to severe pain. The client's blood pressure is 80/54 mm Hg, respirations 10 breaths/min, and pulse 62 beats/min. Which action should the nurse take?

A nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL. Which condition most likely caused this serum phosphorus level?

Which client response best supports the decision to discharge the client from the Post-Anesthesia Care Unit?