ATI custom Fluid and Electrolyte Exam Summer 2023
Total Questions : 45
Showing 25 questions, Sign in for moreA nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding?
Explanation
Choice A rationale:
A phosphorus level of 4.5 mEq/L falls within the normal range, which is typically between 2.5 to 4.5 mEq/L. Although it's essential to monitor phosphorus levels, it is not the priority finding in this scenario.
Choice B rationale:
A potassium level of 2.9 mEq/L is the priority finding. The normal range for potassium is typically between 3.5 to 5.0 mEq/L. A potassium level of 2.9 mEq/L indicates severe hypokalemia, which can lead to life-threatening cardiac arrhythmias and muscle weakness. Immediate intervention is necessary to address the potassium imbalance.
Choice C rationale:
A calcium level of 8.2 mg/dL falls within the normal range (typically 8.5 to 10.2 mg/dL). While calcium levels are essential to monitor, they do not take precedence over the critically low potassium level in this situation.
Choice D rationale:
A sodium level of 145 mEq/L falls within the normal range, which is usually around 135 to 145 mEq/L. Although monitoring sodium levels is important, it is not the priority finding when compared to the critically low potassium level.
A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
Explanation
Choice A rationale:
The client with end-stage renal failure scheduled for dialysis is at risk for fluid volume deficit. Dialysis involves the removal of excess fluid and waste products from the body, which can lead to hypovolemia if not carefully monitored.
Choice B rationale:
The client who has been NPO (nothing by mouth) since midnight for endoscopy is at risk for fluid volume deficit due to prolonged fasting and potential fluid losses during the procedure.
Choice C rationale:
The client with left-sided heart failure and a brain natriuretic peptide (BNP) level of 600 pg/mL is at risk for fluid volume excess (not deficit). Elevated BNP levels indicate increased fluid volume in heart failure patients.
Choice D rationale:
The client with gastroenteritis and fever is at risk for fluid volume deficit due to increased fluid losses from diarrhea and fever-induced diaphoresis.
The nurse is caring for a patient diagnosed with hypocalcemia. What additional assessments should the nurse include when caring for this patient?
Explanation
Other electrolyte disturbances.
Choice A rationale:
Drug toxicity is not directly related to hypocalcemia. The main concern in hypocalcemia is the calcium imbalance itself, not drug toxicity.
Choice B rationale:
Other electrolyte disturbances should be assessed because imbalances in other electrolytes, such as potassium and magnesium, are often associated with hypocalcemia. Electrolyte imbalances can interact and exacerbate each other, potentially leading to more severe complications.
Choice C rationale:
Hypertension is not a typical assessment finding in hypocalcemia. Hypertension is not directly related to calcium levels but may have other underlying causes.
Choice D rationale:
Visual disturbances are not commonly associated with hypocalcemia. Hypocalcemia is more likely to present with neuromuscular and cardiovascular symptoms, rather than visual disturbances.
A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?
Explanation
Choice A rationale:
Fluid volume overload is an excess of fluid in the intravascular and/or interstitial spaces. One of the hallmark signs of fluid volume overload is distended neck veins, which indicates increased venous pressure due to the accumulation of fluid. The neck veins become more visible and prominent, especially when the patient is in a semi-Fowler's position.
Choice B rationale:
Poor skin turgor is a sign of dehydration, not fluid volume overload. It is characterized by the skin's inability to return to its normal position after being gently pinched. In fluid volume overload, the skin may become edematous and puffy, but it does not exhibit poor turgor.
Choice C rationale:
Concentrated hemoglobin and hematocrit levels are seen in conditions of dehydration or hemoconcentration, not in fluid volume overload. In fluid volume overload, there is excess fluid, which may lead to dilutional effects, resulting in decreased concentration of blood components.
Choice D rationale:
Decreased urine output is associated with fluid volume deficit (dehydration) rather than fluid volume overload. In fluid volume overload, there is often an increase in urine output as the body tries to eliminate the excess fluid.
A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, PacO₂ 68 mm Hg, Base excess -2, PaO₂ 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L.
Explanation
Respiratory acidosis.
Choice A rationale:
Metabolic alkalosis occurs when there is an increase in pH and bicarbonate (HCO₃⁻) levels, which is not the case here. The pH value in this scenario is 7.22, indicating acidosis.
Choice B rationale:
Respiratory acidosis results from the retention of carbon dioxide (PaCO₂) in the blood, leading to a decrease in pH. In this case, the pH is low (7.22), and the PacO₂ is elevated (68 mm Hg), supporting the diagnosis of respiratory acidosis.
Choice C rationale:
Metabolic acidosis is characterized by a decrease in pH and bicarbonate levels, along with a possible negative base excess. However, in this scenario, the base excess is -2, which does not indicate metabolic acidosis.
Choice D rationale:
Respiratory alkalosis occurs when there is a decrease in PaCO₂, leading to an increase in blood pH. The ABG values provided (pH 7.22, PacO₂ 68 mm Hg) are not consistent with respiratory alkalosis.
A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?
Explanation
Widened QRS Complexes.
Choice A rationale:
Hyperactive deep tendon reflexes are not typical findings in respiratory acidosis. They are more commonly associated with conditions like hypocalcemia or hypercalcemia.
Choice B rationale:
Warm, flushed skin is not directly related to respiratory acidosis. It is not a typical manifestation of this acid-base imbalance.
Choice C rationale:
Widened QRS complexes on an ECG are characteristic findings in respiratory acidosis. Acidosis can lead to changes in the electrical conduction of the heart, resulting in QRS complex widening.
Choice D rationale:
Bounding peripheral pulses are not directly associated with respiratory acidosis. They may be seen in conditions like hyperthyroidism or anemia but are not specific to respiratory acidosis. Remember, always interpret lab results and clinical findings in the context of the patient's overall condition, medical history, and other relevant factors to provide the best care possible.
The nurse is planning care for a patient with severe burns. What health problem should the nurse realize that this patient could develop?
Explanation
Extracellular fluid deficit.
Choice A rationale:
Intracellular fluid deficit is a decrease in the fluid inside the cells, which may occur in conditions such as diabetic ketoacidosis. Severe burns are more likely to cause extracellular fluid shifts rather than intracellular fluid deficits.
Choice B rationale:
Interstitial fluid deficit involves a decrease in fluid in the interstitial spaces between cells. While burns can lead to fluid shifts, the primary concern is fluid loss from the vascular space (extracellular fluid).
Choice C rationale:
Intracellular fluid overload is not a typical health problem associated with severe burns. Burn injuries are more likely to cause fluid loss and shifts out of the intracellular space.
Choice D rationale:
Severe burns can result in significant loss of plasma and extracellular fluid, leading to hypovolemia and extracellular fluid deficit. This fluid loss can lead to hypovolemic shock and other complications if not adequately managed.
A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.).
Explanation
Choice A rationale:
Lethargy is not typically associated with metabolic alkalosis. Instead, it is commonly seen in metabolic acidosis or other conditions affecting the central nervous system.
Choice B rationale:
Kussmaul's respirations are rapid, deep, and labored breathing patterns that are compensatory mechanisms in response to metabolic alkalosis. They help to decrease the carbon dioxide levels in the blood, attempting to restore the acid-base balance.
Choice C rationale:
Circumoral paresthesia refers to a tingling sensation around the mouth and is a neurological manifestation of metabolic alkalosis, often caused by hypocalcemia.
Choice D rationale:
Bicarbonate excess is essentially the cause of metabolic alkalosis rather than a clinical manifestation. Elevated bicarbonate levels in the blood lead to an increase in pH, resulting in alkalosis.
Choice E rationale:
Flushing is another clinical manifestation of metabolic alkalosis, caused by the altered acid- base balance affecting the peripheral blood vessels.
A patient newly diagnosed with diabetes mellitus is admitted to the emergency department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2 and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse anticipate in this patient? Select all that apply.
Explanation
Choice A rationale:
Dysrhythmias are not a direct consequence of diabetic ketoacidosis (DKA) or the acid-base imbalance indicated by the patient's pH of 7.2 and bicarbonate level of 20 mEq/L. DKA primarily affects the respiratory system, leading to Kussmaul respirations, not dysrhythmias.
Choice B rationale:
Kussmaul respirations are an expected finding in a patient with diabetic ketoacidosis (DKA) and metabolic acidosis. These deep, rapid breaths are the body's attempt to compensate for the acidosis by eliminating excess CO2.
Choice C rationale:
Weakness is a common symptom of DKA. The hyperglycemia and acidosis result in intracellular dehydration and impaired cellular function, leading to weakness and fatigue.
Choice D rationale:
Cold, clammy skin is not typically associated with DKA. Instead, patients with DKA may have warm, dry skin due to dehydration and impaired thermoregulation.
Choice E rationale:
Tachycardia is an expected finding in a patient with DKA. The metabolic acidosis and dehydration lead to an increase in heart rate as the body attempts to maintain perfusion.
A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.
Explanation
Choice A rationale:
Normal saline is not indicated for the treatment of high serum phosphate levels. It is a solution used for fluid resuscitation or hydration but does not have any direct effect on phosphate levels.
Choice B rationale:
Potassium phosphate is a suitable treatment for a patient with a low serum phosphate level (hypophosphatemia). In this case, the patient has a high serum phosphate level, and administering more phosphate would exacerbate the condition.
Choice C rationale:
Additional milk intake is not a suitable treatment for high serum phosphate levels. Milk contains phosphate, which would further elevate the phosphate level.
Choice D rationale:
Increased Vitamin D intake is a valid treatment for high serum phosphate levels (hyperphosphatemia). Vitamin D helps regulate phosphate levels by promoting its excretion.
Choice E rationale:
Calcium-containing antacids are used to bind phosphate in the gastrointestinal tract and reduce its absorption, thus lowering serum phosphate levels. This makes it a suitable treatment for hyperphosphatemia.
A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a Paco2 of 50 mm Hg. The nurse should identify that the client is experiencing which of the following acid-base imbalances?
Explanation
Choice A rationale:
The arterial blood gas results show a low pH (acidosis) and an elevated Paco2 (partial pressure of carbon dioxide), which indicates respiratory acidosis. This condition occurs when there is inadequate removal of carbon dioxide through ventilation, leading to an accumulation of carbonic acid in the blood and a decrease in pH.
Choice B rationale:
Metabolic acidosis would present with a low pH and a low bicarbonate (HCO3-) level, not an elevated Paco2.
Choice C rationale:
Metabolic alkalosis would present with a high pH and an elevated bicarbonate (HCO3-) level, not an elevated Paco2.
Choice D rationale:
Respiratory alkalosis would present with a high pH and a decreased Paco2, not an elevated Paco2 as seen in this case.
A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider?
Explanation
25 mg/dL.
Choice A rationale:
A BUN (Blood Urea Nitrogen) level of 10 mg/dL is within the normal range, indicating normal kidney function. There is no indication to report this value to the provider for a dehydrated client.
Choice B rationale:
A BUN level of 18 mg/dL is within the normal range as well. This value does not suggest significant dehydration, so it is not necessary to report it to the provider in this context.
Choice C rationale:
A BUN level of 13 mg/dL is also within the normal range, and similar to choices A and B, it does not indicate severe dehydration that requires immediate reporting to the provider.
Choice D rationale:
A BUN level of 25 mg/dL is elevated, which may indicate dehydration, kidney dysfunction, or other issues affecting fluid balance. Since the client is dehydrated, this elevated value needs to be reported to the provider for further evaluation and appropriate intervention.
A patient with fluid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? Select all that apply.
Explanation
A, D, and E.
Choice A rationale:
Furosemide is a loop diuretic that promotes diuresis, causing an increase in urine output. It is essential for the patient to expect this effect and understand that it helps in reducing fluid overload.
Choice B rationale:
Feeling weak and dizzy is not an expected effect of furosemide. It is more commonly associated with dehydration or excessive fluid loss, which can occur if the medication causes too much diuresis.
Choice C rationale:
Taking furosemide before going to sleep is not recommended because it can lead to nighttime diuresis, disrupting sleep and potentially causing electrolyte imbalances.
Choice D rationale:
Swelling of the face or hands may indicate an adverse reaction to furosemide or an underlying medical issue. The nurse should instruct the patient to report any such symptoms promptly.
Choice E rationale:
Monitoring body weight daily is crucial for patients on diuretic therapy to assess fluid status and response to treatment. Rapid weight gain may indicate worsening fluid overload, while significant weight loss may indicate excessive diuresis.
A nurse is caring for a client who is receiving an IV infusion of dextrose 10% in water. The nurse should monitor the client for which of the following adverse effects?
Explanation
Choice A rationale:
Hypokalemia is not a direct adverse effect of dextrose 10% in water infusion. This solution does not contain potassium, and unless the patient already has low potassium levels or other contributing factors, it would not cause hypokalemia.
Choice B rationale:
Hypercalcemia is unrelated to dextrose 10% in water infusion. The solution does not contain calcium, and it would not lead to an increase in serum calcium levels.
Choice C rationale:
Hypovolemia, or low blood volume, is not typically associated with dextrose 10% in water infusion. However, if administered rapidly in large amounts, it could potentially cause fluid overload leading to hypervolemia.
Choice D rationale:
Hyperglycemia is a possible adverse effect of dextrose 10% in water infusion. The solution contains a high concentration of glucose, which can raise blood sugar levels if the body cannot adequately utilize or regulate the glucose. Regular monitoring of blood glucose levels is essential during such an infusion, especially in patients with diabetes or impaired glucose tolerance.
The nurse is reviewing the health problems for a group of assigned patients. Which patient does the nurse recognize as being at increased risk for developing metabolic alkalosis?
Explanation
Choice A rationale:
Patients with bulimia are at risk of developing metabolic alkalosis due to repeated episodes of vomiting, which leads to a loss of stomach acid (hydrochloric acid) and an increase in bicarbonate levels. However, this choice is not the correct answer for this question.
Choice B rationale:
Patients with COPD (Chronic Obstructive Pulmonary Disease) are at risk of developing respiratory acidosis, not metabolic alkalosis. In COPD, there is impaired lung function, leading to retention of carbon dioxide and increased levels of carbonic acid in the blood.
Choice C rationale:
Patients with venous stasis ulcer may be at increased risk for developing metabolic alkalosis due to prolonged immobilization. Venous stasis can lead to reduced venous return, which may cause the kidneys to conserve bicarbonate and increase its levels in the blood, resulting in metabolic alkalosis.
Choice D rationale:
Patients on dialysis can experience metabolic imbalances, but they are more likely to develop metabolic acidosis due to the inability of the kidneys to excrete acids effectively.
A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention?
Explanation
Choice A rationale:
Sodium level is a laboratory parameter that can be helpful in assessing fluid balance, but it does not directly measure fluid retention. Abnormal sodium levels may indicate fluid imbalances, but it is not the most reliable measure of fluid retention.
Choice B rationale:
Tissue turgor refers to the skin's elasticity, and it can be used to assess dehydration rather than fluid retention. Poor turgor may indicate dehydration, but it does not specifically measure fluid volume increase.
Choice C rationale:
Daily weight is a reliable measure of fluid retention. An increase in weight over a short period may indicate fluid accumulation in the body, while a decrease in weight could signify fluid loss. It is essential to monitor weight consistently under standardized conditions (e.g., same time, same clothing) for accurate assessment.
Choice D rationale:
Intake and output records provide information about fluid intake and output but may not always reflect fluid retention accurately. It is helpful for assessing fluid balance, but daily weight is a more direct and reliable measure of fluid retention.
A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?
Explanation
Choice A rationale:
Hypocalcemia refers to low levels of calcium in the blood, which can present with symptoms like muscle cramps, numbness, and tingling. However, this choice is not relevant to the patient's symptoms in the scenario.
Choice B rationale:
Hypercalcemia is an electrolyte imbalance characterized by high levels of calcium in the blood. It can lead to ECG changes and symptoms like muscle weakness, confusion, and constipation. However, this is not the correct answer in the given scenario.
Choice C rationale:
The patient's symptoms of ECG changes and muscle weakness are consistent with hyperkalemia. Spironolactone is a potassium-sparing diuretic, and its use can lead to increased potassium levels in the blood (hyperkalemia), which can affect the heart's electrical activity and cause muscle weakness.
Choice D rationale:
Hypokalemia is a condition where there is a low level of potassium in the blood. It can lead to muscle weakness, ECG changes, and other symptoms, but it is not the correct answer in this specific situation involving spironolactone use.
The nurse is caring for a patient who is anxious and dizzy following a traumatic experience. The arterial blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, and HCO3 24. Which intervention should the nurse expect to be prescribed to correct this problem?
Explanation
Choice A rationale:
Encouraging the patient to breathe in and out slowly into a paper bag is not appropriate for this patient's condition. The arterial blood gas findings show a pH of 7.48, indicating respiratory alkalosis (due to decreased PaCO2). Breathing into a paper bag would further decrease the PaCO2, exacerbating the alkalosis and potentially causing adverse effects.
Choice B rationale:
Administering oxygen via a mask and monitoring oxygen saturation is the appropriate intervention for this patient. The arterial blood gas findings indicate an elevated PaO2 (110 mmHg), which suggests an oxygen excess. The patient is likely experiencing hyperventilation due to anxiety, leading to respiratory alkalosis. Providing oxygen via a mask will help correct the alkalosis while ensuring adequate oxygenation.
Choice C rationale:
Anticipating the administration of intravenous sodium bicarbonate is not indicated in this case. The patient's HCO3 level is within the normal range (24 mEq/L), and the primary issue is respiratory alkalosis. Giving sodium bicarbonate would raise the HCO3 levels, potentially causing metabolic alkalosis, which is not the problem at hand.
Choice D rationale:
Preparing to start an intravenous fluid bolus using isotonic fluids is not the appropriate intervention for this situation. The patient's arterial blood gas findings do not indicate any signs of fluid imbalance or electrolyte disturbances that would require intravenous fluid bolus.
A patient with a history of stomach ulcers is diagnosed with hypophosphatemia. What intervention should the nurse include in this patient's plan of care?
Explanation
Choice A rationale:
Hypophosphatemia is a condition characterized by low levels of phosphate in the blood, which can be caused by various factors, including malnutrition. In this case, the patient has a history of stomach ulcers, which might have contributed to poor nutrient absorption. The nurse should request a dietitian consult to ensure the patient receives an appropriate diet rich in phosphorus, which is essential for cellular function, bone health, and energy metabolism.
Choice B rationale:
Providing aluminum hydroxide antacids as prescribed is not the appropriate intervention for hypophosphatemia. Aluminum hydroxide antacids can bind to phosphate in the gastrointestinal tract, reducing its absorption and potentially worsening the patient's already low phosphate levels.
Choice C rationale:
Instructing the patient to avoid poultry, peanuts, and seeds is not suitable for this situation. These foods are good sources of phosphorus, and avoiding them would further deplete the patient's already low phosphate levels.
Choice D rationale:
Instructing the patient to avoid the intake of sodium phosphate is not necessary for hypophosphatemia. While sodium phosphate preparations are used as laxatives, there is no indication that the patient is taking them, and they are not relevant to the management of hypophosphatemia.
A patient with chronic renal failure has an occluded arteriovenous fistula, and routine hemodialysis is delayed. However, the patient's serum potassium level is 6.0 mEq/L. What should the nurse expect to be prescribed for this patient? Select all that apply.
Explanation
A, C, and D.
Choice A rationale:
The administration of sodium bicarbonate helps to correct acidosis, which can occur in chronic renal failure due to the accumulation of metabolic waste products in the absence of effective kidney function.
Choice C rationale:
Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia, which is common in chronic renal failure due to impaired potassium excretion by the kidneys.
Choice D rationale:
Insulin can be prescribed to treat hyperkalemia by promoting the uptake of potassium into cells, thereby reducing the serum potassium level. Choice B and E rationale: Dextrose 10% and furosemide (Lasix) are not appropriate treatments for hyperkalemia. Dextrose 10% is asugar solution and does not impact potassium levels, while furosemide is a loop diuretic that primarily affects sodium and water excretion, not potassium.
A patient experiencing multisystem fluid volume deficit has tachycardia, pale, cool skin, and decreased urine output. The nurse realizes these findings are most likely a direct result of which process?
Explanation
Choice B rationale:
The patient's tachycardia, pale, cool skin, and decreased urine output are signs of the body's natural compensatory mechanisms in response to fluid volume deficit. When the body
experiences a decrease in fluid volume, it tries to compensate by increasing heart rate (tachycardia) to maintain blood flow to vital organs and constricting blood vessels to preserve fluid and maintain blood pressure. Pale, cool skin is a result of vasoconstriction, and decreased urine output is a way the body conserves water during dehydration.
Choice A rationale:
Effects of rapidly infused intravenous fluids are not the cause of the patient's current findings. In fact, the nurse's notes indicate that the IV fluid therapy (0.9% sodium chloride) was initiated at 125 mL/hr, which is a relatively standard and cautious rate. Rapidly infused fluids could potentially cause fluid overload, but that is not the situation here.
Choice C rationale:
Pharmacological effects of a diuretic are not relevant to this patient's presentation. There is no mention of diuretic use in the nurse's notes, and the symptoms presented are more consistent with fluid volume deficit and dehydration rather than diuretic use.
Choice D rationale:
Cardiac failure is not the correct answer, as there is no indication of heart failure in the patient's presentation or nurse's notes. The symptoms and findings described are more indicative of fluid volume deficit, which is not synonymous with cardiac failure.
Exhibit 1. A nurse is teaching a client who is on a low-sodium diet. Which of the following instructions should the nurse include? (Select All that Apply.).
Explanation
A, C, D, and E.
Choice A rationale:
Canned soups are often high in sodium content, which can be detrimental to individuals on a low-sodium diet.
Choice C rationale:
Bottled salad dressings can be high in sodium, so the nurse should recommend making homemade dressings with reduced salt or using low-sodium alternatives.
Choice D rationale:
Reading labels on foods is crucial for identifying their sodium content, enabling the client to make informed choices that align with a low-sodium diet.
Choice E rationale:
Processed meats, such as bacon and deli meats, are generally high in sodium, and replacing them with fresh meat products can help reduce sodium intake.
Choice B rationale:
While diet sodas may be low in sodium, they often contain artificial sweeteners, which might not be ideal for individuals on a low-sodium diet. Bottled water without added sodium or other minerals is a more suitable choice.
A nurse is caring for a client who has a urinary tract infection. History and Physical. Day 1: Medication Administration Record. Furosemide 40 mg po bid. Trimethoprim/sulfamethoxazole 160 mg/800 mg po q12h. Assessment. Nurses Notes. Drag words from the choices below to fill in each blank in the following sentence. The client is at an increased risk for developing:
Explanation
Choice A rationale:
Target conditions are not mentioned in the sentence, and there is no context to suggest their relevance to the client's situation.
Choice B rationale:
Hyperactive reflexes are not commonly associated with a urinary tract infection or the prescribed medications.
Choice C rationale:
The client with a urinary tract infection and the medications mentioned (Furosemide and Trimethoprim/sulfamethoxazole) are at an increased risk of hypokalemia (low potassium levels) due to Furosemide's diuretic effect, fluid volume deficit (dehydration) from the infection, and hypertension (high blood pressure) as a potential side effect of Trimethoprim/sulfamethoxazole.
Choice D rationale:
Urinary retention is not expected in a client with a urinary tract infection; it is more commonly associated with urinary obstruction or other urinary conditions unrelated to an infection.
A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings?
Explanation
Choice A rationale:
Increased urine ketones are not indicative of fluid volume deficit. Instead, they may suggest diabetic ketoacidosis or starvation ketosis.
Choice B rationale:
Decreased Hgb (hemoglobin) is not specific to fluid volume deficit and can be seen in various conditions such as anemia or bleeding.
Choice C rationale:
Decreased urine specific gravity is not consistent with fluid volume deficit, as it usually results in concentrated urine with increased specific gravity.
Choice D rationale:
An increased blood urea nitrogen (BUN) level is expected in fluid volume deficit due to reduced kidney perfusion and function. BUN is a marker of kidney function and is elevated when fluid volume is low.
A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate. If this medication is effective, the nurse should expect which of the following changes on the client's ECG?
Explanation
Choice A rationale:
Restoration of QRS Complex amplitude is not a typical effect of polystyrene sulfonate and is not related to hyperkalemia (high serum potassium levels).
Choice B rationale:
Shortening of P-wave duration is not related to polystyrene sulfonate use or its effects on potassium levels.
Choice C rationale:
Polystyrene sulfonate is used to treat hyperkalemia by exchanging sodium for potassium in the colon, leading to potassium excretion. As potassium levels decrease, the QRS complex on the ECG may widen, indicating a potential reduction in the risk of dangerous cardiac arrhythmias associated with hyperkalemia.
Choice D rationale:
Reduction of T-wave amplitude is not a typical effect of polystyrene sulfonate and is not associated with changes in potassium levels.
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