A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that apply)

Place the client on a cardiac monitor.

Notify the primary health care provider (PHCP).

Put the client on NPO (nothing by mouth) status except for ice chips.

Review the client’s medications to determine whether any contain or retain potassium.

Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte concentration.

Answer and Explanation

Correct Answer : A,B,D

Choice A reason: A potassium level of 7.0 mEq/L risks lethal arrhythmias, necessitating cardiac monitoring. This aligns with hyperkalemia management, making it a correct priority action the nurse would plan to ensure the client’s safety and detect cardiac changes promptly.

Choice B reason: Notifying the provider is critical for a potassium level of 7.0 mEq/L, as urgent interventions like insulin or dialysis may be needed. This aligns with acute care protocols, making it a correct priority action for the nurse to address hyperkalemia.

Choice C reason: NPO status with ice chips is unrelated to hyperkalemia management, which focuses on lowering potassium. Cardiac monitoring is a priority, making this incorrect, as it’s not relevant to the nurse’s urgent actions for a client with severe hyperkalemia.

Choice D reason: Reviewing medications identifies potassium-containing or retaining drugs, preventing further elevation of 7.0 mEq/L. This aligns with hyperkalemia treatment, making it a correct priority action the nurse would plan to manage the client’s electrolyte imbalance effectively.

Choice E reason: Extra IV fluids (500 mL) may dilute potassium but risk fluid overload in acute kidney injury. Notifying the provider is more urgent, making this incorrect, as it’s not a priority compared to the nurse’s focus on immediate hyperkalemia interventions.

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Correct Answer is C

Explanation

Choice A reason: Providing breaths follows compressions in ACLS after defibrillation for pulseless ventricular tachycardia. Resuming compressions is immediate, making this incorrect, as it delays the nurse’s priority to restore circulation post-shock in the client’s code situation.

Choice B reason: Assessing the pulse occurs after 2 minutes of compressions, not immediately post-defibrillation. Resuming compressions is the priority, making this incorrect, as it’s premature compared to the nurse’s focus on continuing CPR in pulseless ventricular tachycardia.

Choice C reason: Resuming chest compressions immediately after defibrillation maintains circulation in pulseless ventricular tachycardia per ACLS guidelines. This aligns with code management, making it the correct next step for the nurse to perform to optimize the client’s resuscitation efforts.

Choice D reason: Epinephrine is given after the second shock or per protocol, not immediately post-defibrillation. Compressions are the priority, making this incorrect, as it’s not the next step in the nurse’s ACLS sequence for managing the client’s arrhythmia.

A. A 26-year-old with hyperparathyroidism. B. A 35-year-old athlete taking NSAIDs for joint pain. C. A 40-year-old taking tetracycline for an infection. D. A 70-year-old who has alcoholism and malnutrition.

Correct Answer is D

Explanation

Choice A reason: Hyperparathyroidism causes hypercalcemia, not hypocalcemia, by increasing calcium levels. Malnutrition in alcoholism depletes calcium, making this incorrect, as it’s the opposite condition compared to the nurse’s recognition of hypocalcemia risk in the client.

Choice B reason: NSAIDs don’t significantly affect calcium levels, unlike malnutrition, which depletes calcium stores. Alcoholism increases hypocalcemia risk, making this incorrect, as it’s not a primary risk factor compared to the nurse’s evaluation of the malnourished client.

Choice C reason: Tetracycline may bind calcium but is less likely to cause hypocalcemia than chronic malnutrition. Alcoholism is a stronger risk, making this incorrect, as it’s a minor factor compared to the nurse’s recognition of hypocalcemia risk in the elderly client.

Choice D reason: A 70-year-old with alcoholism and malnutrition has the greatest hypocalcemia risk due to poor dietary calcium and vitamin D absorption. This aligns with nutritional risk factors, making it the correct client the nurse would recognize as most at risk for hypocalcemia.

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A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Which client will the nurse recognize as having the greatest risk for development of hypocalcemia?

Correct Answer is D

Explanation

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