One week after beginning a new prescription for potassium chloride, a client tells the practical nurse (PN) that there is tingling and numbness in the feet and hands. Which action should the PN take?
Notify the unit charge nurse of the client's reported symptoms immediately.
Reassure the client that the supplement will soon relieve those symptoms.
Explain that a calcium supplement may be necessary.
Encourage the client to decrease the intake of dietary sodium.
The Correct Answer is A
A. Notify the unit charge nurse of the client's reported symptoms immediately: Tingling and numbness can be signs of hyperkalemia, a serious and potentially life-threatening complication from potassium supplementation. Immediate reporting is necessary for prompt evaluation and intervention to prevent cardiac or neuromuscular complications.
B. Reassure the client that the supplement will soon relieve those symptoms: Symptoms like tingling and numbness are not expected side effects of potassium therapy. Reassurance without investigation could delay necessary medical treatment and worsen the client’s condition.
C. Explain that a calcium supplement may be necessary: Calcium supplementation is not the standard response to symptoms of potassium imbalance. Without a clear diagnosis, recommending additional supplements could complicate the clinical situation further.
D. Encourage the client to decrease the intake of dietary sodium: Although reducing sodium is generally beneficial for health, it does not address the acute issue of possible potassium imbalance causing neuromuscular symptoms. Immediate clinical evaluation takes priority.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Standards of practice for practical nursing: While important for general nursing care, national or professional standards do not replace the specific legal requirements outlined by the state’s licensing authority, which directly govern what a PN can and cannot do.
B. The licensing state's PN scope of practice: Each state defines the legal scope of practice for practical nurses, including what tasks they are authorized to perform. Reviewing the specific state's scope of practice ensures the PN practices legally and professionally in the new employment setting.
C. Geriatric standards of care guidelines: Geriatric care guidelines help provide quality care for older adults but are not the first priority when ensuring lawful nursing practice across state lines. Legal requirements must be understood first.
D. The employing agency's procedure manuals: While agency policies are important for specific job performance, they must be aligned with the state's legal scope of practice. Knowing the legal boundaries first is crucial before following any workplace procedures.
Correct Answer is B
Explanation
A. Offer fluids: Offering fluids is not appropriate when the client shows signs of central cyanosis, as it does not address impaired oxygenation and may pose an aspiration risk if the client is hypoxic or has altered mental status.
B. Administer oxygen: Cyanosis of the lips and tongue indicates poor oxygen saturation and tissue hypoxia. Administering oxygen is the priority action to improve oxygen delivery and prevent respiratory compromise.
C. Ask about pain: While assessing pain is important, it is not the priority in the presence of cyanosis, which reflects a potentially life-threatening oxygenation issue requiring immediate intervention.
D. Provide mouth care: Mouth care is not urgent and does not address the underlying problem of hypoxia. It should be deferred until after the client’s oxygenation status is stabilized.
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