A nurse is admitting a client who is experiencing acute adrenal insufficiency. Which of the following prescriptions should the nurse anticipate?
Potassium chloride
Nitroprusside
Hydrocortisone
Spironolactone
The Correct Answer is C
Rationale:
A. Potassium chloride: Clients with acute adrenal insufficiency often present with hyperkalemia due to decreased aldosterone levels, which impair potassium excretion. Administering potassium chloride could worsen this imbalance and lead to dangerous cardiac arrhythmias.
B. Nitroprusside: This is a vasodilator used to manage hypertensive crises, not hypotension. In adrenal insufficiency, patients typically have low blood pressure, and nitroprusside would further reduce it, exacerbating their clinical condition.
C. Hydrocortisone: Hydrocortisone is a glucocorticoid used as the first-line treatment for acute adrenal insufficiency. It replaces deficient cortisol, stabilizes blood pressure, and helps correct electrolyte imbalances and hypoglycemia caused by adrenal crisis.
D. Spironolactone: As a potassium-sparing diuretic, spironolactone can increase serum potassium levels. In the setting of adrenal insufficiency, where hyperkalemia is already a concern, it is not appropriate and may worsen the condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Adjust the heparin dosage based on the client's PT level: PT (prothrombin time) monitors warfarin, not heparin. Heparin dosing is adjusted based on the aPTT, which reflects the intrinsic clotting pathway affected by heparin.
B. Wrap the affected area with cool, moist packs intermittently during the day: Cold packs cause vasoconstriction and are not recommended for clients with DVT. They can potentially increase discomfort and impair circulation in the already compromised limb.
C. Administer vitamin K via IM injection for heparin toxicity: Vitamin K is the reversal agent for warfarin toxicity. Heparin toxicity is treated with protamine sulfate, which neutralizes its anticoagulant effects.
D. Apply thigh-high, sequential compression stockings to the client's legs: Applying thigh-high, sequential compression stockings to the client's legs is a suitable action to promote venous return and prevent blood clots. Compression stockings are commonly used in patients at risk of deep-vein thrombosis.
Correct Answer is B
Explanation
Rationale:
A. Hgb 10 g/dL: This is below the normal range (typically 12–16 g/dL for females, 14–18 g/dL for males) and may indicate anemia, common in kidney injury but not a reliable indicator of nutritional status.
B. Serum albumin 3.7 g/dL: This is within the normal range (3.5–5.0 g/dL) and reflects adequate protein and nutritional intake, making it a reliable indicator in assessing nutritional status.
C. Serum creatinine 2.0 mg/dL: Elevated levels indicate impaired renal function, not nutritional adequacy. This value is common in acute kidney injury but does not assess nutrition directly.
D. BUN 22 mg/dL: Although mildly elevated, BUN can be affected by dehydration, renal function, and protein intake, so it is not a specific indicator of adequate nutrition.
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