A nurse is caring for a client who has hyperkalemia and is to receive intravenous insulin. Which of the following should the nurse recognize as an adverse outcome?

Serum potassium 4.8 mmol/l

Serum glucose 58 mg/d

Serum sodium 138 mEq/L

Calcium level of 100 mg

Answer and Explanation

The Correct Answer is B

A. Serum potassium 4.8 mmol/L: This is a normal potassium level (3.5–5.0 mmol/L) and indicates successful treatment.

B. Serum glucose 58 mg/dL: IV insulin drives potassium into cells, lowering serum potassium. However, insulin also lowers blood glucose, which can lead to hypoglycemia (glucose <70 mg/dL). Hypoglycemia is the primary adverse effect of IV insulin therapy.

C. Serum sodium 138 mEq/L: This is a normal sodium level (135–145 mEq/L) and not an adverse effect.

D. Calcium level of 100 mg: Calcium is not directly affected by IV insulin therapy.

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Correct Answer is C

Explanation

A. During dialysis: Some drugs can bind to the dialysis membrane or be removed unpredictably.

B. Give as scheduled: If given before dialysis, the drugs may be removed from circulation.

C. After returning from dialysis: Dialysis removes medications from the bloodstream. Giving medications before dialysis may result in drug loss. Oral medications should be given after dialysis to ensure proper absorption and effectiveness.

D. Hold the medications for today and restart tomorrow: Unnecessary, as the client needs their medications post-dialysis.

A. Leukocytes B. Hemoglobin C. Platelets D. Brain Natriuretic peptide

Correct Answer is B

Explanation

A. Leukocytes: Erythropoietin does not affect white blood cell (WBC) production.

B. Hemoglobin: Erythropoietin stimulates red blood cell (RBC) production in the bone marrow. Clients with chronic kidney disease (CKD) develop anemia due to decreased natural erythropoietin production. A therapeutic response is seen as an increase in hemoglobin levels.

C. Platelets: Erythropoietin does not stimulate platelet production (thrombopoiesis).

D. Brain Natriuretic Peptide (BNP): BNP is a marker for heart failure, not erythropoiesis.

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A nurse is caring for a client who has hyperkalemia and is to receive intravenous insulin. Which of the following should the nurse recognize as an adverse outcome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client with chronic renal failure is scheduled for hemodialysis at 9 am. They are scheduled to receive oral daily medications. Which statement best describes when the nurse should administer the medications?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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