After receiving the change of shift report, the nurse reviews the electronic health record for each client. What client should the nurse see first?
The client with a serum phosphorus of 4.5 mg/dL that requires assistance with planning their meals
The client with a serum magnesium of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes
The client with a serum potassium of 5.3 mEq/L and is scheduled for hemodialysis in three hours
The client with a serum sodium of 145 mEq/L who is complaining of a dry mouth and wants a glass of water
The Correct Answer is B
A. The client with a serum phosphorus of 4.5 mg/dL that requires assistance with planning their meals: A serum phosphorus level of 4.5 mg/dL is within the normal range, and assistance with meal planning is a lower priority compared to the other situations.
B. The client with a serum magnesium of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes: This client has hypomagnesemia, which can lead to severe complications like seizures or cardiac arrhythmias. Immediate attention is necessary due to the symptoms and the critically low magnesium level.
C. The client with a serum potassium of 5.3 mEq/L and is scheduled for hemodialysis in three hours: This potassium level is slightly elevated, but the scheduled hemodialysis suggests the issue will be addressed soon.
D. The client with a serum sodium of 145 mEq/L who is complaining of a dry mouth and wants a glass of water: A serum sodium of 145 mEq/L is on the high end of normal; the client's dry mouth is concerning but not as urgent as the issues presented by the hypomagnesemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Ask why the client is taking steroid therapy: While understanding the reason for steroid therapy is important, it does not address the immediate need to manage the medication administration.
B. Notify the surgeon immediately: Notifying the surgeon might be necessary if there are specific concerns, but it is not the most immediate action regarding medication administration.
C. Administer an IV equivalent dose of Prednisone: Since the client is NPO, administering an oral medication could be contraindicated. Administering an IV equivalent ensures the client receives the necessary steroid therapy without risking complications from taking oral medication while fasting.
D. Give the oral steroid with a small sip of water: This may not be appropriate due to the NPO status, which typically restricts oral intake.
Correct Answer is C
Explanation
A. Crush the medication and administer it through the tube: Crushing sustained-release medications can alter their release mechanism, leading to potential overdose or ineffective treatment. Sustained-release formulations should not be crushed.
B. Provide the medication orally for the client to swallow: This option is not appropriate because the client has a gastrostomy tube, and oral administration is not suitable for this route.
C. Ask the healthcare provider to prescribe the medication as an elixir for tube administration: This is the correct approach as it ensures the medication is in a form suitable for administration through the gastrostomy tube without altering its release properties.
D. Dissolve the medication in water and administer it through the tube: Dissolving sustained-release tablets is not recommended as it may compromise the medication's intended release mechanism.
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