A nurse is assessing a client with severe pre-eclampsia who is receiving magnesium sulfate infusion.

Which finding should alert the nurse to suspect magnesium toxicity?

Respiratory rate of 10 breaths/min

Deep tendon reflexes of 2+

Urine output of 40 mL/hour

Serum magnesium level of 6 mq/L

Answer and Explanation

The Correct Answer is A

Respiratory rate of 10 breaths/min.

This is a sign of magnesium toxicity, which can occur when a client receives magnesium sulfate infusion for severe pre-eclampsia. Magnesium toxicity can cause muscle weakness, difficulty breathing, irregular heartbeats, and cardiac arrest.

Choice B is wrong because deep tendon reflexes of 2+ are normal and do not indicate magnesium toxicity.

Choice C is wrong because urine output of 40 mL/hour is adequate and does not indicate magnesium toxicity.

The minimum urine output for an adult is 30 mL/hour.

Choice D is wrong because serum magnesium level of 6 mEq/L is within the normal range of 1.7 to 2.3 mEq/L and does not indicate magnesium toxicity. Magnesium levels above 2.6 mEq/L can indicate hypermagnesemia.

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Correct Answer is A

Explanation

Respiratory rate of 10 breaths/minute.This indicates that the client is experiencingmagnesium toxicity, which can causemuscle weakness,difficulty breathing, andcardiac arrest.The normal respiratory rate for adults is 12 to 20 breaths/minute.

Choice B is wrong because deep tendon reflexes of 2+ are normal and do not indicate magnesium toxicity.

Choice C is wrong because urinary output of 40 mL/hour is within the normal range of 30 to 50 mL/hour.Magnesium toxicity can cause urine retention, not increased output.

Choice D is wrong because serum magnesium level of 6 mEq/L is within the normal range of 1.7 to 2.3 mEq/L.Magnesium toxicity occurs when the level is above 2.6 mEq/L.

A. Urinary output of 100 mL in 4 hr B. Respiratory rate of 16/min C. Patellar reflex of +2 D. Serum magnesium level of 4 mEq/L

Correct Answer is A

Explanation

Urinary output of 100 mL in 4 hr is an indication of magnesium sulfate toxicity.Magnesium sulfate is used to prevent seizures in women with severe preeclampsia or eclampsia.Taking too much magnesium can be life-threatening to both mother and child.

Choice B is wrong because

Choice C is wrong because patellar reflex of +2 is normal and not a sign of toxicity.Loss of deep tendon reflexes can occur with magnesium overdose.

Choice D is wrong because serum magnesium level of 4 mEq/L is normal and not a sign of toxicity.Toxic levels are usually above 8 mEq/L.

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A nurse is assessing a client with severe pre-eclampsia who is receiving magnesium sulfate infusion. Which finding should alert the nurse to suspect magnesium toxicity?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with severe pre-eclampsia who is receiving magnesium sulfate. Which assessment finding would indicate that the client is experiencing magnesium toxicity?

Correct Answer is A

Explanation

A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate via continuous IV infusion. Which of the following findings should the nurse identify as an indication of magnesium sulfate toxicity?

Correct Answer is A

Explanation

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A nurse is assessing a client with severe pre-eclampsia who is receiving magnesium sulfate infusion.

Which finding should alert the nurse to suspect magnesium toxicity?