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.

Answer and Explanation

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

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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.

A. Dark-colored urine. B. High blood pressure. C. Distended neck veins. D. Moist skin. E. Moist skin.

Correct Answer is A

Explanation

Choice A rationale

Dark-colored urine is a common symptom of dehydration. When a person is dehydrated, their kidneys try to conserve water by concentrating the urine, which can make it appear darker. Choice B rationale

High blood pressure is not typically associated with dehydration. In fact, dehydration can sometimes lead to low blood pressure due to a decrease in blood volume.

Choice C rationale

Distended neck veins are not typically a symptom of dehydration. They are more commonly associated with conditions that cause fluid overload, such as heart failure.

Choice D rationale

Moist skin is not typically a symptom of dehydration. In fact, one of the symptoms of severe dehydration can be dry, cool skin.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse on a medical-surgical unit suspects that several patients have Clostridium difficile (C. difficile) when they all develop watery diarrhea. What actions should the nurse plan to take while waiting for the patients’ lab results?

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A nurse is collecting data from a patient who has dehydration. What findings should the nurse expect?

Correct Answer is A

Explanation

Choice A rationale

Choice C rationale

Choice D rationale

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