A client with fluid retention is ordered hydrochlorothiazide (Microzide). The nurse provides education about possible electrolyte imbalances related to thiazide diuretic therapy. To help prevent thiazide-related complications, the client should be encouraged to consume foods and fluids that contain which electrolyte?

Calcium

Selenium

Potassium

Bicarbonate

Answer and Explanation

The Correct Answer is C

A. Calcium: Thiazide diuretics can increase calcium levels, but the primary concern is the potential loss of potassium.
B. Selenium: This is not directly related to thiazide diuretic therapy and does not address the primary electrolyte imbalance.
C. Potassium: This is the correct choice. Thiazide diuretics can cause hypokalemia (low potassium levels). Encouraging potassium-rich foods helps to counteract this side effect.
D. Bicarbonate: While bicarbonate can be important for acid-base balance, it is not the primary concern with thiazide diuretics, which typically affect potassium levels.

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Correct Answer is C

Explanation

A. Serum potassium 5.0 mEq/L: This is within the normal range for serum potassium (3.5-5.0 mEq/L). While potassium levels are important, they are not the primary concern with symptoms of confusion and a bounding pulse due to excessive water intake.
B. Serum osmolality 294 mmol/kg: This value is within the normal range for serum osmolality (275-295 mmol/kg). Elevated or normal osmolality would not be expected in a case of water intoxication, which dilutes serum electrolytes.
C. Serum sodium of 127 mEq/L: A serum sodium level of 127 mEq/L indicates hyponatremia, a condition often caused by excessive water intake that dilutes the sodium in the bloodstream. Symptoms such as confusion, headache, and a full bounding pulse are consistent with hyponatremia, making this the expected abnormality.
D. Serum hemoglobin 15.7 grams/dL: This is within the normal range for hemoglobin (12-16 grams/dL for women and 13.8-17.2 grams/dL for men). Hemoglobin levels would not be expected to change significantly due to water intoxication.

A. "Maybe you are more depressed than you realize. Would you like to talk about it?" B. "Depression is often a factor in pain. Treating the depression helps treat the pain." C. "Why don't you try it for a while, and if you don't feel better, you can ask your doctor if you can stop it?" D. "Antidepressants are sometimes used to manage the type of nerve pain you are experiencing."

Correct Answer is D

Explanation

A. "Maybe you are more depressed than you realize. Would you like to talk about it?": This response may dismiss the client's concerns and assumes depression without explaining the rationale for the medication.
B. "Depression is often a factor in pain. Treating the depression helps treat the pain.": While this may be true, it might not address the specific rationale for the antidepressant in managing nerve pain.
C. "Why don't you try it for a while, and if you don't feel better, you can ask your doctor if you can stop it?": This response lacks an explanation and may not address the client’s concerns about why the medication was prescribed.
D. "Antidepressants are sometimes used to manage the type of nerve pain you are experiencing.": This is the correct choice. It directly addresses the use of antidepressants for managing neuropathic pain, which can be effective even in the absence of depression.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client with peripheral neuropathy states, "I don't know why the doctor put me on an antidepressant. I am not depressed!" Which response by the nurse is best?

Correct Answer is D

Explanation

The nurse working on a medical surgical unit is assigned four clients at the start of their shift. What client should be given the highest priority?

A client has been receiving IV potassium therapy. Upon further assessment, the nurse notes the site has become erythematous and edematous. Which action by the nurse is most appropriate?

A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

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?

The nurse is providing care for several clients at risk for acid-base imbalance. Which client has the greatest risk for respiratory acidosis?

A client with leukemia is expected to require chemotherapy for several months. Which type of IV line will best meet the client's needs?

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The nurse is asked to witness surgical consent forms were obtained for clients, in the preoperative holding area. What client would not be able to consent legally to surgery?