A nurse is caring for a client.
Drag words from the choices below to fill in each blank in the following sentence.
The nurse is assessing the client. The client's
The Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"A"}
Rationale for Correct Choices:
- Heart rate: The client’s heart rate has increased from 58/min to 118/min, indicating possible thyrotoxicosis or over-replacement of levothyroxine. Tachycardia is a priority finding because it can lead to cardiovascular complications such as arrhythmias or chest pain.
- Pain: The client reports chest pain, which, combined with tachycardia and elevated blood pressure, may indicate cardiac strain or complications. Prompt assessment of pain helps identify potential cardiovascular compromise requiring urgent intervention.
Rationale for Incorrect Choices
- Weight: While notable changes in weight are important for monitoring thyroid treatment, they are not immediately life-threatening compared with tachycardia and chest pain.
- Skin: Skin changes provide supportive assessment information but are less immediately critical than cardiovascular status.
- Temperature: Elevated temperature indicates hypermetabolism or possible infection, but it is not as immediately life-threatening as the tachycardia and chest pain.
- Bowel sounds: Hyperactive bowel sounds reflect increased GI motility but are less urgent compared with cardiovascular and metabolic indicators.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Seizures: Seizures are not an indication for potassium chloride administration. While severe electrolyte imbalances can contribute to seizures, potassium replacement is specifically indicated for low potassium levels rather than seizure management.
B. Kidney transplant: Kidney transplant patients may require careful electrolyte monitoring, but potassium chloride is not automatically indicated unless hypokalemia is present. Administration is based on lab values, not transplant status alone.
C. Arrhythmia: Hypokalemia can cause cardiac arrhythmias due to altered myocardial excitability. Potassium chloride is administered to correct low potassium levels and help prevent or treat arrhythmias.
D. Endocarditis: Endocarditis is an infection of the heart valves and is treated with antibiotics. Potassium chloride does not play a role in treating bacterial infections or inflammation of the heart.
Correct Answer is ["60"]
Explanation
Calculation:
- Determine the concentration of the available solution in mg/mL.
Total drug amount: 2g
Total volume: 500mL
- Convert grams (g) to milligrams (mg): 2g × 1000mg/g
= 2000mg
Available concentration (mg/mL) = 2000mg/500mL
= 4mg/mL.
- Calculate the infusion rate in milliliters per minute (mL/min).
Desired rate: 4mg/min
Available concentration: 4mg/mL
Rate (mL/min) = Desired rate (mg/min) / Available concentration (mg/mL)
= 4mg/min/4mg/mL
= 1mL/min.
- Convert the rate from milliliters per minute (mL/min) to milliliters per hour (mL/hr).
Rate (mL/hr) = Rate (mL/min) ×60min/hr
= 1mL/min×60min/hr
= 60mL/hr.
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