A client at risk for developing hyperkalemia states, "I love fruit and usually eat it every day, but now I can't because of my high potassium level." How should the nurse respond?

"Potatoes and avocados can be substituted for fruit."

"If you cook the fruit, the amount of potassium will be lower."

"Berries, cherries, apples, and peaches are low in potassium."

"You are correct. Fruit is very high in potassium."

Answer and Explanation

The Correct Answer is C

A. "Potatoes and avocados can be substituted for fruit.": Both potatoes and avocados are actually high in potassium, so they are not suitable substitutes for the client. This response could further exacerbate the risk for hyperkalemia.

B. "If you cook the fruit, the amount of potassium will be lower.": Boiling, can slightly reduce the potassium content. However, the reduction is not substantial enough to make high-potassium fruits completely safe for someone with severe hyperkalemia,

C. "Berries, cherries, apples, and peaches are low in potassium.": Berries, cherries, apples, and peaches are indeed lower in potassium compared to many other fruits, making them a suitable option for a client at risk for hyperkalemia.

D. "You are correct. Fruit is very high in potassium.": While some fruits are high in potassium, not all fruits are, and some are low in potassium. This statement would be misleading and may unnecessarily discourage the client from eating fruit.

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Correct Answer is B

Explanation

A. Excessive thirst: Excessive thirst, polydipsia, is not the most immediate concern with a potassium level of 5.2 mEq/L. Potassium levels within this range (slightly elevated) may not directly cause excessive thirst.

B. Irregular heartbeat: Elevated potassium levels can cause dangerous cardiac arrhythmias, including irregular heartbeat. Therefore, the most important assessment is monitoring for signs of cardiac disturbances.

C. Swelling of ankles: Swelling of the ankles is more commonly associated with fluid retention or circulatory issues and is not directly linked to minor elevations in potassium levels. Although elevated potassium can affect fluid balance, it does not immediately present as swelling.

D. Frightening hallucinations: Hallucinations can be caused by a variety of factors, but they are not a direct effect of slightly elevated potassium levels. More serious symptoms like cardiac arrhythmias are a more immediate concern with abnormal potassium levels.

Correct Answer is ["44"]

Explanation

Calculation:

Convert the infusion rate from milliliters per hour (mL/hr) to milliliters per minute (mL/min).

Infusion rate in mL/min = 175 mL/hr / 60 min/hr

= 2.9166... mL/min.

Tubing drop factor = 15 gtt/mL.

Calculate the flow rate in drops per minute (gtt/min).

Flow rate (gtt/min) = Infusion rate (mL/min) × Tubing drop factor (gtt/mL)

= 2.9166... mL/min × 15 gtt/mL

= 43.75 gtt/min.

Round the answer to the nearest whole number.

= 44 gtt/min.

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A client at risk for developing hyperkalemia states, "I love fruit and usually eat it every day, but now I can't because of my high potassium level." How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The K laboratory report shows a level of 5.2 mEq/L (Normal 3.5-5.0 mEq/L). What is the most important assessment for the nurse to make?

Correct Answer is B

Explanation

The physician orders 500 mL of NS to infuse at 175 mL/h for a patient with vomiting. Tubing drop factor is 15 gtt/mL. Calculate the flow rate in drops per minute.

Correct Answer is ["44"]

Explanation

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