A nurse is collecting data from a client who has heart failure and takes chlorothiazide sodium. Which of the following findings should the nurse identify as indicating hypokalemia?
Restlessness
Hyperactive bowel sounds
Decreased deep-tendon reflexes
Bounding peripheral pulses
The Correct Answer is C
A. Restlessness:
Restlessness is not typically associated with hypokalemia. Instead, it may indicate anxiety, discomfort, or other factors unrelated to electrolyte imbalances.
B. Hyperactive bowel sounds:
Hyperactive bowel sounds are often associated with increased gastrointestinal motility, which may occur in conditions such as diarrhea or gastroenteritis. While electrolyte imbalances can contribute to gastrointestinal symptoms, hyperactive bowel sounds are not specific to hypokalemia.
C. Decreased deep-tendon reflexes:
Hypokalemia can lead to decreased deep-tendon reflexes due to its effects on nerve conduction. Potassium is essential for proper nerve and muscle function, and low levels can impair reflexes.
D. Bounding peripheral pulses:
Bounding peripheral pulses are not typically associated with hypokalemia. Instead, they may indicate increased cardiac output or volume overload, which can occur in conditions such as heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
A) "If a client refuses a medication, you can place it in your pocket to administer later."
This statement is incorrect. Placing a medication in the pocket for later administration is not an appropriate practice and can lead to unauthorized possession and potential diversion of controlled substances. However, the second part of the statement, "You are required to have a second nurse witness disposal of a controlled substance," is correct.
B) "We use an automated dispensing device to track the use of controlled substances."
Automated dispensing devices are commonly used to track the administration and removal of controlled substances. This helps to ensure accountability and prevents diversion.
C) "Activities of the automated dispensing machine will be reviewed periodically."
Regular review of the activities of the automated dispensing machine helps to monitor for any discrepancies or irregularities in the handling of controlled substances, thus enhancing safety measures.
D) "We count the amount of a controlled substance available before removal from a medication drawer."
Counting the amount of controlled substance available before removal from a medication drawer is a crucial step in ensuring accurate inventory management and preventing unauthorized removal or diversion.
Correct Answer is ["A","C","D"]
Explanation
(A) Correctly identify clients prior to administering medications: This is a key goal of the National Patient Safety Goals (NPSGs). Correctly identifying patients before administering medications helps to prevent medication errors and ensures patient safety.
(B) Educate clients about health promotion and prevention: While this is an important aspect of nursing care, it is not specifically listed as a National Patient Safety Goal.
(c) Prevent catheter-associated urinary tract infections in clients: Preventing healthcare-associated infections, including catheter-associated urinary tract infections, is a major focus of the NPSGs.
(D) Improve communication among staff members: Effective communication among healthcare providers is crucial for patient safety and is a key goal of the NPSGs.
(E) Increase job satisfaction for staff members: While job satisfaction can indirectly impact patient safety, it is not a specific goal of the NPSGs. The NPSGs are primarily focused on direct measures to improve patient safety.
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