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: Promoting positive nitrogen balance is critical for postsurgical wound healing, as it indicates adequate protein intake for tissue repair. Surgery increases metabolic demand, depleting amino acids needed for collagen synthesis and immune function. Positive balance supports fibroblast activity and wound tensile strength, reducing infection risk and promoting recovery in the healing process.

Choice B reason: Neutral nitrogen balance maintains protein homeostasis but is insufficient for postsurgical patients, who require excess protein for tissue repair. Surgery induces catabolism, increasing nitrogen loss via urine. Neutral balance does not provide the surplus amino acids needed for collagen formation and immune response, slowing wound healing and increasing complication risks.

Choice C reason: Reducing dependent nitrogen balance is not a recognized medical goal. Nitrogen balance reflects protein metabolism, critical for wound healing. Postsurgical patients need positive balance to supply amino acids for tissue regeneration. This option is vague and irrelevant, as it does not address the physiological need for increased protein synthesis post-surgery.

Choice D reason: Maintaining negative nitrogen balance indicates protein catabolism exceeding synthesis, detrimental to wound healing. Postsurgical stress increases cortisol, promoting protein breakdown. Negative balance impairs collagen production and immune function, delaying wound closure and increasing infection risk. Positive nitrogen balance is essential to support tissue repair and recovery in surgical patients.

A. The patient can share a hospital room with a roommate. B. Use of a mask is not required. C. Patients will be in a positive pressure airflow room. D. Patients will be in a negative pressure airflow exchange room.

Correct Answer is D

Explanation

Choice A reason: Sharing a room with a roommate is contraindicated for tuberculosis, as airborne precautions prevent droplet nuclei transmission. Tuberculosis spreads via inhalation, and a shared room increases infection risk for others, violating isolation protocols, per infection control and respiratory disease management standards.

Choice B reason: Not requiring a mask contradicts airborne precautions, as tuberculosis requires N95 respirators for healthcare workers to block droplet nuclei. Masks are essential to prevent inhalation of infectious particles, ensuring safety during patient contact, per tuberculosis-specific infection control guidelines.

Choice C reason: Positive pressure airflow rooms are used for immunocompromised patients to prevent infections, not for tuberculosis, which requires negative pressure to contain airborne particles. Positive pressure would spread infectious droplets, increasing transmission risk, contrary to airborne precaution requirements, per infection control engineering.

Choice D reason: A negative pressure airflow room is required for tuberculosis to prevent airborne droplet nuclei from escaping, containing infectious particles. This ensures safe isolation, protecting staff and patients by directing airflow inward, aligning with airborne precautions, per CDC tuberculosis infection control guidelines.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient with a postsurgical wound. When planning care, which goal will be the priority?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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