A nurse is caring for a client with chronic kidney disease (CKD) who presents with hyperkalemia. Which of the following interventions should the nurse implement first?

Administer sodium polystyrene sulfonate as prescribed.

Monitor the client’s cardiac rhythm.

Restrict dietary potassium intake.

Prepare the client for hemodialysis.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Administering sodium polystyrene sulfonate helps to lower potassium levels by exchanging sodium ions for potassium ions in the intestines. However, it is not the first intervention because it takes time to work and does not address the immediate risk of cardiac arrhythmias caused by hyperkalemia.
Choice B rationale
Monitoring the client’s cardiac rhythm is the first intervention because hyperkalemia can cause life-threatening cardiac arrhythmias. Continuous cardiac monitoring allows for the early detection and treatment of these arrhythmias, which is crucial for the client’s safety.
Choice C rationale
Restricting dietary potassium intake is an important long-term management strategy for hyperkalemia, especially in clients with chronic kidney disease. However, it does not address the immediate risk of cardiac arrhythmias and is not the first intervention.
Choice D rationale
Preparing the client for hemodialysis is a definitive treatment for hyperkalemia, especially in clients with chronic kidney disease. However, it is not the first intervention because it takes time to arrange and initiate dialysis. Immediate cardiac monitoring is necessary to manage the acute risk of arrhythmias.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A rationale
Severe headache and photophobia are classic symptoms of meningitis, indicating inflammation of the meninges.
Choice B rationale
Chest pain and shortness of breath are more indicative of cardiovascular or respiratory issues, not meningitis.
Choice C rationale
Abdominal pain and diarrhea are gastrointestinal symptoms and are not typically associated with meningitis.
Choice D rationale
Joint pain and swelling are more indicative of rheumatologic conditions, not meningitis.

A. Hypercalcemia: increased absorption of calcium from the gut into the blood. B. A positive Chvostek’s sign: hypocalcemia. C. Tetany: hyperpolarization. D. Hyperphosphatemia: inability to absorb phosphate from the gut into the blood.

Correct Answer is B

Explanation

Choice A rationale
Hypercalcemia is characterized by increased calcium levels in the blood, often due to increased absorption of calcium from the gut. However, in chronic kidney disease (CKD), the kidneys’ ability to activate vitamin D is impaired, leading to decreased calcium absorption from the gut, not increased. Therefore, hypercalcemia is not a typical sign of CKD1.
Choice B rationale
A positive Chvostek’s sign is indicative of hypocalcemia, which is a common symptom in CKD. The kidneys’ reduced ability to activate vitamin D leads to decreased calcium absorption from the gut, resulting in low calcium levels in the blood. This hypocalcemia can cause neuromuscular irritability, leading to a positive Chvostek’s sign.
Choice C rationale
Tetany is a condition characterized by muscle cramps and spasms, often due to hypocalcemia. In CKD, hypocalcemia occurs due to the kidneys’ inability to activate vitamin D, leading to decreased calcium absorption from the gut. This hypocalcemia can cause hyperexcitability of nerves and muscles, resulting in tetany.
Choice D rationale
Hyperphosphatemia is characterized by high phosphate levels in the blood. In CKD, the kidneys’ ability to excrete phosphate is impaired, leading to its accumulation in the blood. However, this is not directly related to the inability to absorb phosphate from the gut but rather the kidneys’ reduced excretion capacity.

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A nurse is caring for a client with chronic kidney disease (CKD) who presents with hyperkalemia. Which of the following interventions should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client with suspected meningitis. Which of the following symptoms would most likely indicate meningitis?

Correct Answer is A

Explanation

A patient with chronic kidney disease usually has a decrease in the ability to activate vitamin D, likely resulting in signs and symptoms (S&S) such as:

Correct Answer is B

Explanation

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