An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Hyperkalemia

Hyponatremia

Fluid volume excess

Hypernatremia

Answer and Explanation

The Correct Answer is B

Choice A: Hyperkalemia is not an imbalance that this patient is demonstrating, because this condition occurs when the blood potassium level is too high. This can happen in patients who have renal failure, acidosis, or excessive potassium intake. Hyperkalemia can cause muscle weakness, cardiac arrhythmias, and paralysis.

Choice B: Hyponatremia is an imbalance that this patient is demonstrating, because this condition occurs when the blood sodium level is too low. This can happen in patients who have watery diarrhea, which causes the loss of sodium and water from the body. Hyponatremia can cause abdominal and muscle cramping, nausea, confusion, and seizures.

Choice C: Fluid volume excess is not an imbalance that this patient is demonstrating, because this condition occurs when the body retains more ﬂuid than it excretes. This can happen in patients who have heart failure, kidney failure, or excessive ﬂuid intake. Fluid volume excess can cause edema, distended neck veins, and crackles in the lungs.

Choice D: Hypernatremia is not an imbalance that this patient is demonstrating, because this condition occurs when the blood sodium level is too high. This can happen in patients who have dehydration, diabetes insipidus, or excessive sodium intake. Hypernatremia can cause thirst, dry mucous membranes, agitation, and coma.

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Correct Answer is C

Explanation

Choice A: Client is currently prescribed spironolactone is incorrect because spironolactone is a potassium-sparing diuretic that can cause hyperkalemia, or high potassium level, not hypokalemia, or low potassium level. Spironolactone works by blocking the action of aldosterone, which is a hormone that regulates sodium and potassium balance in the body.

Choice B: Client reports drinking 3.5 to 4 L of water each day is incorrect because drinking excessive water can cause hyponatremia, or low sodium level, not hypokalemia. Hyponatremia occurs when the water intake exceeds the water output, diluting the sodium concentration in the blood.

Choice C: Client has an NG tube to gastric suction is correct because gastric suction can cause hypokalemia by removing gastric ﬂuids that contain potassium. Gastric suction can also cause metabolic alkalosis, which is a condition where the blood pH is high and the HCO3 is high, indicating a loss of metabolic acids or an excess of bicarbonate in the body. Metabolic alkalosis can cause potassium to shift from the extracellular ﬂuid to the intracellular ﬂuid, thus lowering the serum potassium level.

Choice D: Client has a history of alcohol abuse disorder is incorrect because alcohol abuse can cause hypomagnesemia, or low magnesium level, not hypokalemia. Hypomagnesemia occurs when there is inadequate intake or excessive loss of magnesium, which is an essential mineral for many enzymatic reactions in the body.

Hypomagnesemia can impair the secretion and action of parathyroid hormone, which regulates calcium and phosphorus balance in the body.

A. A client who is taking a thiazide diuretic B. A client who has diarrhea C. A client who is vomiting D. A client who has salicylate intoxication

Correct Answer is B

Explanation

Choice A: A client who is taking a thiazide diuretic is not at risk for metabolic acidosis, but rather for metabolic alkalosis. This is a condition that occurs when the body has too much bicarbonate or loses too much acid. This can happen in patients who take thiazide diuretics, which increase the excretion of sodium, chloride, and water, but also cause the retention of bicarbonate.

Choice B: A client who has diarrhea is at risk for metabolic acidosis, because this condition occurs when the body produces too much acid or loses too much bicarbonate. This can happen in patients who have diarrhea, which causes the loss of intestinal ﬂuids that contain bicarbonate and other bases.

Choice C: A client who is vomiting is not at risk for metabolic acidosis, but rather for metabolic alkalosis. This is a condition that occurs when the body has too much bicarbonate or loses too much acid. This can happen in patients who have vomiting, which causes the loss of gastric ﬂuids that contain hydrochloric acid and other acids.

Choice D: A client who has salicylate intoxication is at risk for metabolic acidosis, because this condition occurs when the body produces too much acid or loses too much bicarbonate. This can happen in patients who have salicylate intoxication, which is a toxic reaction to aspirin or other salicylates. Salicylates increase the production of organic acids and interfere with the renal excretion of acids.

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An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor?

Correct Answer is C

Explanation

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is B

Explanation

A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.

A patient is diagnosed with hypokalemia. After reviewing the patient's current medications, which drug should the nurse consider that might have contributed to the patient's health problem?

The nurse is reviewing the health problems for a group of assigned patients. Which patient does the nurse recognize as being at increased risk for developing metabolic alkalosis?

A patient newly diagnosed with diabetes mellitus is admitted to the emergency department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2 and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse anticipate in this patient? Select all that apply.

A nurse is caring for a client who is receiving IV ﬂuids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the client is eﬀectively responding to treatment?

The patient who has a serum magnesium level of 1.4 mg/dL is being treated with dietary modification. Which foods should the nurse suggest for this patient?

A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect?

A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider?