A nurse is caring for a client who has dyspnea, crackles, and 3+ bilateral pitting pedal edema. Which of the following serum sodium levels should the nurse identify as an indication of fluid volume excess?

167 mEq/L

142 mEq/L

136 mEq/L

116 mEq/L

Answer and Explanation

The Correct Answer is D

Rationale:

A. 167 mEq/L: This indicates hypernatremia, which is typically associated with fluid volume deficit due to water loss, not fluid overload.

B. 142 mEq/L: This is a normal sodium level and does not indicate fluid imbalance on its own.

C. 136 mEq/L: Also within the normal reference range (135–145 mEq/L) and does not signal fluid excess.

D. 116 mEq/L: This level represents severe hyponatremia, commonly seen in fluid volume excess. In conditions like heart failure or renal failure, water retention can dilute serum sodium. The patient’s symptoms (dyspnea, crackles, and edema) are consistent with fluid overload and dilutional hyponatremia.

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Correct Answer is A

Explanation

Rationale:
A. A serum potassium of 6.5 mEq/L indicates hyperkalemia, which can occur in acidosis as hydrogen ions shift into cells and potassium shifts out. Flaccid paralysis is a serious neuromuscular manifestation of severe hyperkalemia and supports a diagnosis of acidosis.
B. A potassium level of 4.5 mEq/L is normal, and hyperactive DTRs are more often associated with alkalosis, not acidosis.
C. A sodium level of 144 mEq/L is normal, and while tachycardia may occur in many conditions, it is nonspecific and does not indicate acidosis.
D. A sodium level of 130 mEq/L indicates hyponatremia, and peripheral edema is more related to fluid imbalance or heart failure, not acidosis.

A. Hypoactive bowel sounds B. Skeletal muscle weakness C. Tingling of the lips D. Decreased deep-tendon reflexes

Correct Answer is C

Explanation

Rationale:
A. Hypoactive bowel sounds are more commonly associated with hypercalcemia or other electrolyte imbalances like hypokalemia.
B. Skeletal muscle weakness is a sign of hypercalcemia, not hypocalcemia.
C. Tingling of the lips (paresthesia) is a classic symptom of hypocalcemia, often accompanied by numbness and tingling in the fingers and around the mouth.
D. Decreased deep-tendon reflexes are associated with hypercalcemia; hypocalcemia typically causes increased neuromuscular excitability, such as hyperactive reflexes and muscle cramps.

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A nurse is caring for a client who has dyspnea, crackles, and 3+ bilateral pitting pedal edema. Which of the following serum sodium levels should the nurse identify as an indication of fluid volume excess?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which laboratory data and clinical manifestations cause you to suspect your client may be experiencing acidosis?

Correct Answer is A

Explanation

A nurse is collecting data from a client who has hypocalcemia. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

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