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 D

Explanation

Choice A reason: Showing positions for holding a newborn addresses the psychomotor domain, teaching physical skills. The affective domain involves emotions and attitudes, not physical techniques. This action helps parents learn how to feed but does not explore their feelings or beliefs, which is the focus of affective learning.

Choice B reason: Explaining bottle-warming steps targets the cognitive domain, focusing on knowledge and procedure. It does not address emotions or attitudes, which are central to the affective domain. This action provides technical understanding but does not engage the parents’ feelings or values about newborn care.

Choice C reason: Having parents demonstrate diaper changing is a psychomotor activity, emphasizing skill acquisition. The affective domain involves feelings and attitudes, not physical tasks. While this builds confidence, it does not directly address emotional engagement or beliefs, which are necessary for affective learning in this context.

Choice D reason: Asking about breastfeeding views targets the affective domain by exploring parents’ emotions, beliefs, and attitudes. This encourages reflection on personal values, fostering emotional engagement with newborn care. Addressing these feelings helps build confidence and commitment, aligning with affective learning goals in nursing education.

A. Take the client for a walk and ask them to talk about their family B. Administer alprazolam to decrease their anxiety C. Administer olanzapine to decrease their agitation D. Take the client to their room so they will not upset others

Correct Answer is A

Explanation

Choice A reason: Engaging the client in a walk and family discussion uses therapeutic communication and redirection, common in dementia care. This non-pharmacological approach validates emotions, reduces distress, and promotes calmness by shifting focus to positive memories, aligning with person-centered care principles to address emotional needs first.

Choice B reason: Alprazolam, a benzodiazepine, reduces anxiety but carries risks like sedation and falls in dementia patients. Pharmacological interventions should be secondary to non-pharmacological approaches, as they may exacerbate confusion or dependency. Addressing emotional distress through engagement is preferred before considering medications for anxiety management.

Choice C reason: Olanzapine, an antipsychotic, is used for severe agitation or psychosis in dementia. It poses risks like sedation, extrapyramidal symptoms, and increased mortality in elderly patients. Non-pharmacological interventions, like redirection, are prioritized to manage emotional distress safely, reserving medications for when behavioral approaches fail.

Choice D reason: Isolating the client in their room may increase distress and agitation in dementia patients, as it does not address their emotional needs. Social isolation can worsen confusion and feelings of abandonment. Therapeutic engagement, such as redirection or validation, is more effective in calming the client and fostering trust.

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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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indicate the nurse is addressing the affective domain of learning?

Correct Answer is D

Explanation

A nurse in a long-term care facility is caring for a client with dementia who is upset over not being able to find their spouse, who passed away years ago. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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As the nurse assesses a client’s blood pressure, the patient’s wrist severely flexes inward. The nurse questions the client’s response because this finding may indicate what condition?

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