A nurse is assessing a client who has an electrolyte imbalance with an elevated total calcium level of 12.8 mg/dL. Which of the following findings should the nurse expect?

Hyperreflexia

Diarrhea

Muscle twitching

Lethargy

Answer and Explanation

The Correct Answer is D

A) Hyperreflexia:
Hyperreflexia is typically associated with low calcium levels (hypocalcemia), not elevated levels. An elevated calcium level often results in reduced neuromuscular excitability, leading to diminished reflexes rather than heightened ones.

B) Diarrhea:
Elevated calcium levels are more likely to cause constipation rather than diarrhea. Hypercalcemia often slows gastrointestinal motility, which can lead to decreased bowel movements and constipation.

C) Muscle twitching:
Muscle twitching is generally a symptom of hypocalcemia rather than hypercalcemia. Elevated calcium levels tend to depress neuromuscular activity, making muscle twitching less likely.

D) Lethargy:
Lethargy is a common symptom of hypercalcemia. High calcium levels can depress the central nervous system, leading to symptoms such as fatigue, weakness, confusion, and lethargy. This makes lethargy a likely finding in a client with an elevated total calcium level.

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Correct Answer is A

Explanation

A) "I can add lean turkey to a salad.": Lean turkey is a good source of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based sources. Including iron-rich foods like lean turkey in the diet helps address iron-deficiency anemia effectively.

B) "I should choose apples over strawberries.": Apples are not particularly high in iron compared to strawberries. While apples provide some nutrients, strawberries contain more vitamin C, which enhances iron absorption from other foods.

C) "I can take an iron supplement with milk to enhance the effect.": Milk and other dairy products can inhibit iron absorption due to their calcium content. It is recommended to take iron supplements with vitamin C-rich beverages like orange juice to enhance absorption.

D) "I should consume coffee or tea with my meals.": Coffee and tea contain compounds like polyphenols that can inhibit iron absorption when consumed with meals. It's better to avoid these beverages around meal times to improve iron absorption.

A. Position the cast on a plastic-covered pillow. B. Perform neurovascular checks every 2 hr. C. Instruct the client to avoid moving the fingers on the left hand. D. Touch the cast with the palms of the hands when moving the client.

Correct Answer is B

Explanation

A) Position the cast on a plastic-covered pillow:
Positioning the cast on a plastic-covered pillow is not recommended because the plastic can trap moisture and heat, potentially affecting the cast's integrity as it dries. Instead, a soft, absorbent material should be used to support the cast.

B) Perform neurovascular checks every 2 hr:
Frequent neurovascular checks are essential to monitor for complications such as compartment syndrome, nerve damage, or impaired circulation. This action helps ensure that any changes in sensation, movement, or circulation are identified and addressed promptly.

C) Instruct the client to avoid moving the fingers on the left hand:
Encouraging the client to move their fingers is important to prevent stiffness and swelling and to promote circulation. Instructing the client to avoid moving their fingers is not appropriate and could lead to complications.

D) Touch the cast with the palms of the hands when moving the client:
Handling a wet plaster cast with the palms of the hands is correct to prevent indentations and pressure points that could cause skin irritation or pressure sores. However, this action is not as critical as performing frequent neurovascular checks to ensure the client's safety and monitor for complications.

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A nurse is assessing a client who has an electrolyte imbalance with an elevated total calcium level of 12.8 mg/dL. Which of the following findings should the nurse expect?

Nursing Test Bank

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