A nurse is reviewing the laboratory values of a patient receiving total parenteral nutrition (TPN). The glucose is 72 mg/dL, chloride is 100 mEq/L, sodium is 138 mEq/L, and potassium is 3.0 mEq/L. What action should the nurse plan to take?
Administer glucagon IM.
Discontinue the TPN infusion.
Request a potassium replacement.
Check the patient for a positive Chvostek’s sign.
The Correct Answer is C
The correct answer is Choice C.
Step 1 is to interpret the laboratory values. The glucose level is within the normal range (7099 mg/dL). The chloride level is within the normal range (97-107 mEq/L). The sodium level is within the normal range (135-145 mEq/L). However, the potassium level is low (normal range is 3.5-5.0 mEq/L)89101112.
Step 2 is to plan the action based on the interpretation. Given the low potassium level, the nurse should plan to request a potassium replacement
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
An increased blood osmolarity, such as 260 mOsm/kg, can be a sign of dehydration. When the body is dehydrated, the concentration of solutes in the blood can increase, leading to higher osmolarity.
Choice B rationale
Hypotension, or low blood pressure, is not typically a sign of dehydration. In fact, dehydration can often cause blood pressure to increase due to the body’s efforts to compensate for the lack of fluid.
Choice C rationale
A high urine specific gravity, such as 1.035, can indicate dehydration. This measurement reflects the concentration of solutes in the urine, and a high value can mean that the body is conserving water due to dehydration.
Choice D rationale
An elevated blood sodium level, such as 150 mEq/L, can be a sign of dehydration. When the body is dehydrated, the concentration of sodium in the blood can increase.
Correct Answer is D
Explanation
Choice A rationale
Requesting the providers to initiate antibiotic therapy for every patient on the unit is not the most appropriate action. Antibiotics should only be used when there is a confirmed bacterial infection. Overuse of antibiotics can lead to antibiotic resistance and can potentially trigger C. difficile infection due to disruption of normal gut flora.
Choice B rationale
While performing hand hygiene with an alcohol-based agent is important in general infection control, it is not the most effective measure against C. difficile.
C. difficile spores are resistant to destruction by alcohol-based hand rubs. Therefore, hand hygiene for C. difficile should involve washing with soap and water.
Choice C rationale
Obtaining stool cultures from all patients on the nursing unit is not the most appropriate action. Stool cultures should be obtained from patients who are symptomatic. Testing asymptomatic patients can lead to false positives and unnecessary treatment.
Choice D rationale
Placing all patients who have symptoms on contact precautions is the correct answer. Contact precautions, including the use of gloves and gowns, can prevent the spread of C. difficile. This is because C. difficile is spread via the fecal-oral route, and its spores can survive on surfaces for long periods.
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