A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

Hypernatremia

Hyperglycemia

Hypercalcemia

Hyperkalemia

Answer and Explanation

The Correct Answer is B

A. Hypernatremia: This condition involves elevated sodium levels, which is not directly addressed by the insulin and dextrose order.
B. Hyperglycemia: While dextrose can exacerbate hyperglycemia, the order of insulin and dextrose is not for managing hyperglycemia but for another purpose.
C. Hypercalcemia: This condition involves elevated calcium levels and is not related to the use of insulin and dextrose.
D. Hyperkalemia: The administration of regular insulin with dextrose is often used to manage hyperkalemia. Insulin helps shift potassium into cells, while dextrose prevents hypoglycemia resulting from the insulin.

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Correct Answer is A

Explanation

A. Kayexalate (sodium polystyrene): This is the correct choice. Kayexalate is used to treat hyperkalemia (high serum potassium levels) by facilitating the removal of excess potassium from the body through the gastrointestinal tract.
B. Potassium chloride: This is used to treat hypokalemia (low potassium levels), not hyperkalemia.
C. Sodium bicarbonate: This can be used to correct metabolic acidosis and may indirectly help with potassium levels, but it is not the primary treatment for hyperkalemia.
D. Aldactone (spironolactone): This is a potassium-sparing diuretic that can increase potassium levels, which would be contraindicated in the case of hyperkalemia.

A. Level of consciousness B. Condition of drains C. Appearance of the surgical dressing D. Stability of vital signs

Correct Answer is D

Explanation

A. Level of consciousness: While important, it follows the assessment of vital signs to ensure the client's overall stability.
B. Condition of drains: This is relevant but not as immediate as assessing the stability of vital signs.
C. Appearance of the surgical dressing: This is important but secondary to ensuring the client’s vital signs are stable.
D. Stability of vital signs: This is the most critical next assessment after ensuring a patent airway, as vital signs reflect the client's immediate physiological status and stability.

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A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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