A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?

Hypocalcemia.

Hypercalcemia.

Hyperkalemia.

Hypokalemia.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Hypocalcemia refers to low levels of calcium in the blood, which can present with symptoms like muscle cramps, numbness, and tingling. However, this choice is not relevant to the patient's symptoms in the scenario.

Choice B rationale:

Hypercalcemia is an electrolyte imbalance characterized by high levels of calcium in the blood. It can lead to ECG changes and symptoms like muscle weakness, confusion, and constipation. However, this is not the correct answer in the given scenario.

Choice C rationale:

The patient's symptoms of ECG changes and muscle weakness are consistent with hyperkalemia. Spironolactone is a potassium-sparing diuretic, and its use can lead to increased potassium levels in the blood (hyperkalemia), which can affect the heart's electrical activity and cause muscle weakness.

Choice D rationale:

Hypokalemia is a condition where there is a low level of potassium in the blood. It can lead to muscle weakness, ECG changes, and other symptoms, but it is not the correct answer in this specific situation involving spironolactone use.

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Correct Answer is A

Explanation

The correct answer is choice A: Encourage the patient to breathe in and out slowly into a paper bag.

Choice A rationale:The patient’s arterial blood gas (ABG) results indicate respiratory alkalosis, as evidenced by the elevated pH (7.48) and decreased PaCO2 (25 mm Hg). Respiratory alkalosis often results from hyperventilation, which can occur due to anxiety. Breathing into a paper bag helps to increase CO2 levels in the blood, thereby correcting the alkalosis.

Choice B rationale:Administering oxygen is not appropriate in this scenario because the patient’s PaO2 is already elevated (110 mm Hg), indicating that oxygenation is not the issue. Providing additional oxygen would not address the underlying problem of hyperventilation and respiratory alkalosis.

Choice C rationale:Intravenous sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis. In this case, the patient’s HCO3 is within the normal range (24 mEq/L), indicating that there is no metabolic acidosis present.

Choice D rationale:Starting an intravenous fluid bolus with isotonic fluids is not indicated for correcting respiratory alkalosis. This intervention is more appropriate for patients experiencing hypovolemia or dehydration, which is not suggested by the patient’s ABG results.

A. 10 mg/dL. B. 18 mg/dL. C. 13 mg/dL. D. 25 mg/dL.

Correct Answer is D

Explanation

25 mg/dL.

Choice A rationale:

A BUN (Blood Urea Nitrogen) level of 10 mg/dL is within the normal range, indicating normal kidney function. There is no indication to report this value to the provider for a dehydrated client.

Choice B rationale:

A BUN level of 18 mg/dL is within the normal range as well. This value does not suggest significant dehydration, so it is not necessary to report it to the provider in this context.

Choice C rationale:

A BUN level of 13 mg/dL is also within the normal range, and similar to choices A and B, it does not indicate severe dehydration that requires immediate reporting to the provider.

Choice D rationale:

A BUN level of 25 mg/dL is elevated, which may indicate dehydration, kidney dysfunction, or other issues affecting fluid balance. Since the client is dehydrated, this elevated value needs to be reported to the provider for further evaluation and appropriate intervention.

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A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who is anxious and dizzy following a traumatic experience. The arterial blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, and HCO3 24. Which intervention should the nurse expect to be prescribed to correct this problem?

Correct Answer is A

Explanation

A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider?

Correct Answer is D

Explanation

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