As the nurse assesses a client’s laboratory values, the following are noted: Sodium 140 mEq/L, Magnesium 0.8 mEq/L, Chloride 107 mEq/L, Potassium 3.6 mEq/L. What electrolyte imbalance is indicated?

Hypomagnesemia

Hyponatremia

Hyperchloremia

Hypokalemia

Answer and Explanation

The Correct Answer is A

Choice A reason: Hypomagnesemia, low magnesium (normal 1.7–2.2 mg/dL), is indicated by the 0.8 mEq/L value. Magnesium is vital for muscle, nerve, and cardiac function. Low levels can cause tremors, seizures, and arrhythmias. The other values (sodium, chloride, potassium) are within normal ranges, making hypomagnesemia the primary imbalance.

Choice B reason: Hyponatremia, low sodium (normal 135–145 mEq/L), is not indicated, as the sodium level is 140 mEq/L, within normal limits. Hyponatremia can cause neurological symptoms like confusion, but the lab values do not support this diagnosis, and magnesium imbalance is the clear abnormality.

Choice C reason: Hyperchloremia, high chloride (normal 98–106 mEq/L), is not present, as the chloride level is 107 mEq/L, just above normal and not clinically significant. Elevated chloride may occur in dehydration or renal issues, but the primary concern here is the significantly low magnesium level.

Choice D reason: Hypokalemia, low potassium (normal 3.5–5.0 mEq/L), is not indicated, as the potassium level is 3.6 mEq/L, within normal range. Hypokalemia causes muscle weakness and arrhythmias, but the lab values point to hypomagnesemia as the primary electrolyte imbalance in this case.

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Correct Answer is C

Explanation

Choice A reason: Postoperative pain in a 47-year-old is concerning but not immediately life-threatening unless severe or accompanied by other symptoms (e.g., hemorrhage). Pain management is important, but fluid and electrolyte imbalances from vomiting and diarrhea in an elderly client pose a greater immediate risk, requiring urgent assessment.

Choice B reason: Refusal to ambulate in a 20-year-old postoperative client risks complications like thrombosis but is not an acute emergency. Immobility requires intervention, but dehydration and electrolyte imbalances in an elderly client with vomiting and diarrhea are more urgent, as they can rapidly lead to life-threatening hypovolemia.

Choice C reason: An 88-year-old with vomiting and diarrhea for 2 days is at high risk for dehydration, electrolyte imbalances, and hypovolemia, especially given age-related reduced physiological reserves. This can lead to shock or organ failure, making it the highest priority for immediate assessment to stabilize fluid and electrolyte status.

Choice D reason: A stable 60-year-old post-myocardial infarction client is not an immediate priority unless new symptoms arise. Stability suggests no acute changes in cardiac status. Vomiting and diarrhea in an elderly client pose a greater immediate risk due to potential rapid deterioration from fluid loss.

A. Hyperchloremia B. Hypercalcemia C. Hypocalcemia D. Hypomagnesemia

Correct Answer is C

Explanation

Choice A reason: Hyperchloremia, elevated chloride levels, is associated with metabolic acidosis or dehydration, not neuromuscular symptoms like wrist flexion. Chloride imbalances affect acid-base balance, not calcium-dependent muscle contractions. The inward wrist flexion suggests a neuromuscular excitability issue, which is more characteristic of low calcium levels than chloride abnormalities.

Choice B reason: Hypercalcemia, high calcium levels, causes muscle weakness, lethargy, and reduced reflexes, not increased neuromuscular excitability like wrist flexion. Calcium excess stabilizes nerve membranes, reducing spasms. The symptom described aligns with hypocalcemia, where low calcium increases nerve excitability, leading to tetany or abnormal muscle contractions.

Choice C reason: Hypocalcemia, low calcium levels, increases neuromuscular excitability due to decreased stabilization of nerve membranes. This can cause tetany, characterized by involuntary muscle contractions, such as wrist flexion (carpopedal spasm). The symptom is a classic sign of hypocalcemia, often seen in conditions like hypoparathyroidism or vitamin D deficiency.

Choice D reason: Hypomagnesemia, low magnesium, can cause neuromuscular symptoms like tremors or seizures but is less commonly associated with specific signs like wrist flexion. Magnesium affects muscle relaxation, and its deficiency typically causes generalized excitability. Hypocalcemia is more directly linked to tetany and carpopedal spasms, as seen in the client.

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As the nurse assesses a client’s laboratory values, the following are noted: Sodium 140 mEq/L, Magnesium 0.8 mEq/L, Chloride 107 mEq/L, Potassium 3.6 mEq/L. What electrolyte imbalance is indicated?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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