An athlete runs 5 miles a day. His wife notices that after he runs, he becomes lethargic and pale. He is still talking and responding appropriately. After being taken to the E.R., and having his lab work assessed, which lab value might the nurse be most concerned with?

Sodium (Na+) 125 mEq/L

Potassium (K+) 4.2 mEq/L

Calcium (Ca+) 4.8 mg/dL

Magnesium (Mg+) 2.0 mEq/L

Answer and Explanation

The Correct Answer is A

Choice A reason: Sodium 125 mEq/L (normal 135-145 mEq/L) indicates hyponatremia, likely from excessive sweating during running, causing water retention or sodium loss. Low sodium disrupts cellular osmosis, leading to cerebral edema, explaining lethargy and pallor. This critical imbalance affects nerve conduction and muscle function, requiring urgent correction to prevent seizures or coma.

Choice B reason: Potassium 4.2 mEq/L (normal 3.5-5.0 mEq/L) is within normal range. Potassium regulates muscle and nerve function, including cardiac rhythm. Normal levels do not explain lethargy or pallor, as they ensure proper membrane potential and muscle contraction. In this scenario, potassium is not a concern compared to severe hyponatremia affecting neurological status.

Choice C reason: Calcium 4.8 mg/dL (normal 8.5-10.2 mg/dL) indicates hypocalcemia, which can cause muscle cramps or tetany. However, lethargy and pallor are more directly linked to hyponatremia’s neurological effects. Calcium affects muscle contraction and nerve signaling, but its impact is less acute than sodium’s role in osmotic balance and cerebral function here.

Choice D reason: Magnesium 2.0 mEq/L (normal 1.7-2.2 mEq/L) is normal. Magnesium supports muscle and nerve function, including ATP production. Normal levels do not contribute to lethargy or pallor, which are more likely due to sodium imbalance affecting brain hydration. Magnesium is not a priority concern in this acute presentation.

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Correct Answer is A

Explanation

Choice A reason: Administering eye drops to the lower conjunctival sac ensures optimal drug absorption and minimizes corneal irritation. The conjunctival sac, a mucous membrane, allows medication to spread across the eye surface, treating conjunctivitis by targeting bacterial or inflammatory processes. This method avoids systemic absorption via the nasolacrimal duct, enhancing local efficacy and safety.

Choice B reason: Dropping medication onto the cornea risks irritation or injury, as the cornea is a sensitive, avascular tissue responsible for light refraction. Conjunctivitis treatment requires medication to contact the conjunctiva, not the cornea directly. This method could cause discomfort and reduce drug efficacy, as it does not target the inflamed conjunctival tissue.

Choice C reason: The sclera by the outer canthus is not ideal for eye drop administration. The sclera, a tough connective tissue, has poor drug absorption compared to the conjunctival sac. Drops placed here may run off, reducing contact with the inflamed conjunctiva in conjunctivitis, leading to ineffective treatment and potential waste of medication.

Choice D reason: The sclera by the inner canthus is near the nasolacrimal duct, increasing the risk of systemic drug absorption rather than local treatment of conjunctivitis. Drops should target the lower conjunctival sac to ensure contact with the inflamed tissue, maximizing therapeutic effect while minimizing systemic side effects like tachycardia from certain medications.

A. Hypertension. B. A dysrhythmia. C. Tachycardia. D. Bradycardia.

Correct Answer is B

Explanation

Choice A reason: Hypertension is defined by elevated blood pressure, not an irregular heart rate. An irregular pattern at 72 bpm suggests a rhythm abnormality, not a pressure issue. Hypertension affects vascular resistance, not cardiac rhythm directly, making this incorrect for the observed finding, per cardiovascular physiology.

Choice B reason: A dysrhythmia is indicated by an irregular heart rate pattern at 72 bpm, as it reflects abnormal electrical conduction, such as atrial fibrillation or premature beats. Notifying the provider is appropriate, as dysrhythmias may impair cardiac output or indicate underlying pathology, requiring prompt evaluation, per cardiac monitoring protocols.

Choice C reason: Tachycardia is a heart rate above 100 bpm, not applicable to 72 bpm. The irregularity, not speed, is the concern. Tachycardia involves rapid but often regular rhythms, whereas this finding suggests a dysrhythmia, making this choice incorrect for the described clinical presentation, per cardiac assessment.

Choice D reason: Bradycardia is a heart rate below 60 bpm, not matching 72 bpm. The irregular pattern points to a dysrhythmia, not a slow rate. Bradycardia affects heart rate frequency, not rhythm irregularity, making this irrelevant to the finding, which requires rhythm-focused intervention, per cardiac physiology.

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An athlete runs 5 miles a day. His wife notices that after he runs, he becomes lethargic and pale. He is still talking and responding appropriately. After being taken to the E.R., and having his lab work assessed, which lab value might the nurse be most concerned with?

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Naxlex Comprehensive Predictor Exams

The nurse is to administer eye drops four times per day to a patient diagnosed with conjunctivitis. The nurse should administer the medication by gently dropping the medication onto which of the following areas?

Correct Answer is A

Explanation

Upon auscultation of a client's heart rate, the nurse notes the rate to have an irregular pattern of 72 bpm. The nurse notifies the health care provider because the client is exhibiting signs of:

Correct Answer is B

Explanation

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