A nurse is caring for an endurance athlete admitted for altered mental status. The client drank large amounts of water during a recent long-distance running event. The client is confused, complaining of a headache, and has a full bounding pulse. The nurse develops the plan of care based on the expectation that the client's lab work will demonstrate which of the following abnormalities?
Serum potassium 5.0 mEq/L
Serum osmolality 294 mmol/kg
Serum sodium of 127 mEq/L
Serum hemoglobin 15.7 grams/dL
The Correct Answer is C
A. Serum potassium 5.0 mEq/L: This is within the normal range for serum potassium (3.5-5.0 mEq/L). While potassium levels are important, they are not the primary concern with symptoms of confusion and a bounding pulse due to excessive water intake.
B. Serum osmolality 294 mmol/kg: This value is within the normal range for serum osmolality (275-295 mmol/kg). Elevated or normal osmolality would not be expected in a case of water intoxication, which dilutes serum electrolytes.
C. Serum sodium of 127 mEq/L: A serum sodium level of 127 mEq/L indicates hyponatremia, a condition often caused by excessive water intake that dilutes the sodium in the bloodstream. Symptoms such as confusion, headache, and a full bounding pulse are consistent with hyponatremia, making this the expected abnormality.
D. Serum hemoglobin 15.7 grams/dL: This is within the normal range for hemoglobin (12-16 grams/dL for women and 13.8-17.2 grams/dL for men). Hemoglobin levels would not be expected to change significantly due to water intoxication.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Steak and scrambled eggs: Steak and scrambled eggs are excellent sources of heme iron, which is highly bioavailable and easily absorbed by the body. This choice reflects a good understanding of dietary sources rich in iron.
B. Cornmeal muffin and orange juice: While orange juice can enhance iron absorption due to its vitamin C content, cornmeal muffins are not a significant source of iron. This option does not indicate a strong understanding of iron-rich foods.
C. Cantaloupe and cottage cheese: Both cantaloupe and cottage cheese are low in iron content. This menu choice does not reflect an understanding of the best dietary sources of iron.
D. Strawberry pancakes and coffee: Strawberries have some iron, but not in significant amounts, and coffee can inhibit iron absorption due to its polyphenol content. This choice does not indicate an understanding of iron-rich foods.
Correct Answer is D
Explanation
A. "Maybe you are more depressed than you realize. Would you like to talk about it?": This response may dismiss the client's concerns and assumes depression without explaining the rationale for the medication.
B. "Depression is often a factor in pain. Treating the depression helps treat the pain.": While this may be true, it might not address the specific rationale for the antidepressant in managing nerve pain.
C. "Why don't you try it for a while, and if you don't feel better, you can ask your doctor if you can stop it?": This response lacks an explanation and may not address the client’s concerns about why the medication was prescribed.
D. "Antidepressants are sometimes used to manage the type of nerve pain you are experiencing.": This is the correct choice. It directly addresses the use of antidepressants for managing neuropathic pain, which can be effective even in the absence of depression.
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