A nurse is caring for a 58-year-old client who has a low oxygen saturation. The nurse is reviewing the client's data to create a plan of care. Complete the diagram by drawing arrows to connect the condition and two parameters the nurse should monitor to assess the client's progress.
Low oxygen saturation -> Respiratory rate and heart rate
Low oxygen saturation -> Blood pressure and temperature
Low oxygen saturation -> Lung sounds and chest expansion
Low oxygen saturation -> Hemoglobin and hematocrit
The Correct Answer is C
Choice A reason: Respiratory rate and heart rate are not specific indicators of oxygen saturation. They can be affected by many other factors, such as pain, anxiety, or dehydration.
Choice B reason: Blood pressure and temperature are not directly related to oxygen saturation. They can be influenced by other conditions, such as infection, inflammation, or shock.
Choice C reason: Lung sounds and chest expansion are relevant parameters to monitor for a client with low oxygen saturation. They can indicate the presence of respiratory problems, such as pneumonia, asthma, or atelectasis, that can impair gas exchange and oxygen delivery.
Choice D reason: Hemoglobin and hematocrit are measures of red blood cell count and volume. They can affect the oxygen-carrying capacity of the blood, but they are not directly affected by oxygen saturation. They can be altered by other factors, such as bleeding, dehydration, or anemia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Hyperkalemia is not the correct answer. Hyperkalemia is a high level of potassium in the blood. Corticosteroids do not cause hyperkalemia, but rather hypokalemia. Hyperkalemia may be caused by other factors such as renal failure, acidosis, or potassium-sparing diuretics.
Choice B reason: Hypokalemia is the correct answer. Hypokalemia is a low level of potassium in the blood. Corticosteroids can cause hypokalemia by increasing the excretion of potassium and sodium in the urine. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.
Choice C reason: Hypermagnesemia is not the correct answer. Hypermagnesemia is a high level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypermagnesemia may be caused by other factors such as renal failure, excessive antacid use, or magnesium-containing laxatives.
Choice D reason: Hypomagnesemia is not the correct answer. Hypomagnesemia is a low level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypomagnesemia may be caused by other factors such as malnutrition, alcoholism, or diuretic use.
Correct Answer is C
Explanation
Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.
Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.
Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.
Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.
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