After receiving change-of-shift report, which client should the nurse assess first?
Client with serum phosphorus level of 4.5 mg/dL.
Client with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes.
Client with serum potassium level of 5.0 mEq/L who is complaining of abdominal cramping.
Client with serum sodium level of 145 mEq/L who has a dry mouth and is asking for a glass of water.
The Correct Answer is B
A. Client with serum phosphorus level of 4.5 mg/dL: This is within the normal range for phosphorus (2.5-4.5 mg/dL), and the client does not require immediate assessment.
B. Client with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes: This is the correct answer. A magnesium level of 1.1 mEq/L is below the normal range (1.5-2.5 mEq/L), and symptoms like tremors and hyperactive reflexes indicate hypomagnesemia, which can lead to serious complications such as arrhythmias.
C. Client with serum potassium level of 5.0 mEq/L who is complaining of abdominal cramping: A potassium level of 5.0 mEq/L is within the normal range (3.5-5.0 mEq/L), so this client does not need immediate intervention.
D. Client with serum sodium level of 145 mEq/L who has a dry mouth and is asking for a glass of water: A sodium level of 145 mEq/L is at the upper end of normal (135-145 mEq/L), and the symptoms are likely due to dehydration or a normal response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Certain antihistamines can worsen urinary retention in BPH, so informing the allergist is a good practice.
B. Alcohol, including wine, can worsen the symptoms of BPH by increasing urinary retention and bladder discomfort. The client needs further teaching regarding the effects of alcohol on BPH symptoms.
C. It is advisable to avoid large volumes of fluids in the morning, as this can exacerbate BPH symptoms.
D. Caffeine can irritate the bladder and worsen BPH symptoms, so weaning off coffee is a helpful measure.
Correct Answer is D
Explanation
A. Hypercalcemia (Calcium > 10.5 mg/dL) can lead to shortened QT intervals, not prolonged ones, and is unlikely to cause Torsades de Pointes.
B. A magnesium level of 3.1 mEq/L is slightly elevated and would not contribute to QT prolongation or Torsades de Pointes. In fact, magnesium supplementation is a treatment for this condition.
C. Hypokalemia (Potassium < 3.5 mEq/L) can prolong the QT interval and contribute to dysrhythmias, but it is less commonly a direct cause of Torsades de Pointes compared to hypomagnesemia. A potassium level of 2.6 mEq/L is low but would not typically result in Torsades without coexisting hypomagnesemia.
D. Hypomagnesemia (Magnesium < 1.5 mEq/L) disrupts the heart's electrical activity, prolonging the QT interval and increasing the risk of polymorphic ventricular tachycardia, like Torsades de Pointes. Magnesium is critical for stabilizing myocardial electrical conduction, and a value of 1.1 mEq/L indicates significant deficiency, consistent with this dysrhythmia.
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