A nurse is caring for a client who has chronic diarrhea. Which of the following findings should the nurse expect?

Respiratory acidosis

Hypermagnesemia

Hypertension

Hypokalemia

Answer and Explanation

The Correct Answer is D

A. Respiratory acidosis is incorrect. Chronic diarrhea typically leads to metabolic acidosis, not respiratory acidosis. Metabolic acidosis occurs due to the loss of bicarbonate through diarrhea, which affects the body’s acid-base balance.

B. Hypermagnesemia is incorrect. Chronic diarrhea is more likely to lead to hypomagnesemia due to the loss of electrolytes through frequent bowel movements, not an increase in magnesium levels.

C. Hypertension is incorrect. Chronic diarrhea generally leads to dehydration and hypotension due to fluid loss rather than high blood pressure.

D. Hypokalemia is correct. Chronic diarrhea causes significant potassium loss, which can result in hypokalemia (low potassium levels). Potassium is lost in the stool, and this depletion can lead to muscle weakness, arrhythmias, and other complications.

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Correct Answer is D

Explanation

A. Telling the AP to list the steps of the task is not sufficient to ensure correct performance. It may show knowledge of the steps, but it does not ensure the AP is performing the task correctly or safely.

B. Instructing the AP to report back once the task is complete does not allow the nurse to actively observe the AP’s technique or provide feedback on performance.

C. Asking the family if the AP performed the task correctly may provide subjective input, but the nurse is responsible for assessing and ensuring the proper completion of nursing tasks.

D. Requesting the AP to provide a return demonstration of the task is the best method. This allows the nurse to directly observe the AP’s technique, correct any errors, and ensure that the task is performed according to the prescribed standards. This also serves as a valuable teaching opportunity.

A. Place the client in an orthopneic position. B. Provide the client with three large meals each day. C. Encourage the client to cough and deep breathe once every 8 hr. D. Limit fluid intake to 1,000 ml daily.

Correct Answer is A

Explanation

A. Placing the client in an orthopneic position is correct. The orthopneic position (sitting upright and leaning forward. helps clients with COPD breathe more easily by maximizing lung expansion and easing the work of breathing. This position is often used in clients with chronic respiratory conditions to alleviate dyspnea.

B. Providing the client with three large meals is incorrect. Clients with COPD may have difficulty eating large meals because it can interfere with breathing due to increased diaphragm pressure. Instead, small, frequent meals are recommended to reduce the workload on the respiratory system.

C. Encouraging the client to cough and deep breathe once every 8 hr is incorrect. In clients with COPD, frequent coughing and deep breathing exercises are important to promote airway clearance and lung expansion. The nurse should encourage these activities more often than every 8 hours, especially to help clear mucus.

D. Limiting fluid intake to 1,000 ml daily is incorrect. Adequate hydration is essential in COPD clients to help thin secretions and promote easier expectoration. A restriction on fluids could lead to thickened mucus and worsened respiratory status.

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A nurse is caring for a client who has chronic diarrhea. Which of the following findings should the nurse expect?

Nursing Test Bank

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