A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?

Check the client's most recent potassium level

Administer a bolus of 1,000 mL of normal saline

Administer potassium chloride intravenously (IV)

Administer sodium polystyrene sulfonate (Kayexalate)

Answer and Explanation

The Correct Answer is A

A.   Peaked T-waves and a widened QRS complex on an ECG are often signs of hyperkalemia, which is an elevated potassium level in the blood. This can be a serious complication of acute kidney injury (AKI), especially in the oliguric phase when the kidneys are unable to effectively excrete potassium.A
B.   While fluid management is important in AKI, administering a bolus of normal saline is not the first priority in the presence of suspected hyperkalemia. The primary concern is to address the electrolyte imbalance.

C.   Administering potassium chloride would worsen hyperkalemia and should be avoided.
D.   Kayexalate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the gastrointestinal tract. However, checking the potassium level is the first step in confirming the diagnosis and determining the appropriate treatment.

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Correct Answer is C

Explanation

A. Bradycardia, or a slow heart rate, is not typically associated with thyrotoxic crisis. In fact, thyrotoxic crisis usually causes tachycardia (rapid heart rate) due to the body's heightened metabolism and sympathetic nervous system stimulation.
B. Hypotension, or low blood pressure, is not characteristic of a thyrotoxic crisis. The condition typically causes hypertension (elevated blood pressure) as part of the body's stress response and increased metabolic rate.
C. Hyperthermia, or elevated body temperature, is a key sign of thyrotoxic crisis. The condition leads to a hypermetabolic state that can significantly increase body temperature. This high fever is a result of the body's excessive heat production due to the overstimulation of metabolic processes.
D. Constipation is not typically associated with thyrotoxic crisis. In hyperthyroidism, and consequently in thyrotoxic crisis, patients usually experience diarrhea or increased bowel movements due to the increased metabolic rate and gastrointestinal motility.

A. Retinal detachment B. Cataracts C. Age-related macular degeneration D. Open-angle glaucoma

Correct Answer is A

Explanation

A. Floaters and flashes of light are classic symptoms of retinal detachment. When the retina begins to detach from the underlying tissue, it can cause these visual disturbances. Floaters are small, shadowy shapes that move across the field of vision, while flashes of light can occur due to the retina being stretched or pulled.
B. Cataracts primarily cause blurred vision, difficulty seeing at night, and sensitivity to light, rather than floaters or flashes of light.
C. AMD generally affects central vision and can cause symptoms such as distorted vision, difficulty seeing in low light, and a loss of central vision. While AMD can cause vision changes, it is not typically associated with seeing floaters and flashes of light.
D. Open-angle glaucoma usually progresses slowly and is often asymptomatic in its early stages. It primarily affects peripheral vision, leading to a gradual loss of vision in the periphery.

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A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is 12 hours postoperative following a thyroidectomy. Which of the following findings is indicative of thyrotoxic crisis?

Correct Answer is C

Explanation

A client with diabetes and hypertension describes seeing "floaters" and flashes of light in their field of vision. The nurse understands that this description is indicative of which disorder?

Correct Answer is A

Explanation

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