A nurse is collecting data from a client who is in renal failure. The nurse should identify which of the following findings is a manifestation of hyperkalemia.
Dry mucous membranes
Irregular heart rate
Hyperactive reflexes
Trousseau's sign
The Correct Answer is B
A. Incorrect. Dry mucous membranes are not typically associated with hyperkalemia.
B. Correct. Hyperkalemia can lead to cardiac dysrhythmias, including irregular heart rate.
C. Incorrect. Hyperactive reflexes are more commonly associated with hypokalemia (low potassium levels.
D. Incorrect. Trousseau's sign is a clinical indicator of hypocalcemia, not hyperkalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Pancreatitis typically results in elevated serum lipase and amylase levels due to pancreatic inflammation.
B. Incorrect. Decreased albumin might be seen in conditions affecting liver function or malnutrition but is not specific to pancreatitis.
C. Incorrect. Elevated ammonia levels are often associated with liver dysfunction rather than pancreatitis.
D. Incorrect. Prolonged PT/INR are indicators of impaired clotting, usually associated with liver disease rather than pancreatitis.
Correct Answer is B
Explanation
A. Incorrect. Recurring urinary tract infections are related to health and hygiene and are not typically considered external stressors.
B. Correct. A recent move to a new city is an external stressor because it is an environmental change that can lead to feelings of stress and adjustment.
C. Incorrect. Lack of nutritional knowledge is an internal stressor related to the client's knowledge and awareness, not an external factor.
D. Incorrect. Feeling depressed is an internal emotional state and is not an external stressor.
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