Patient Data

Based on the client’s history and clinical findings, which of the following laboratory tests should the nurse anticipate the provider will order first?

Serum potassium, sodium, and magnesium

Liver function tests (ALT, AST, bilirubin)

Hemoglobin A1c and fasting glucose

Complete blood count (CBC) with differential

Answer and Explanation

The Correct Answer is A

Rationale:
A. Serum potassium, sodium, and magnesium: The client presents with severe vomiting and diarrhea, which can cause significant electrolyte losses. Her symptoms are classic signs of electrolyte imbalances, particularly hypokalemia, hypomagnesemia, and hyponatremia. Rapid assessment of electrolytes is critical to prevent life-threatening cardiac arrhythmias, especially given her history of heart failure and coronary artery disease.

B. Liver function tests (ALT, AST, bilirubin): While liver function tests are useful for evaluating hepatic status, the client’s acute presentation is more consistent with electrolyte disturbances than liver disease. LFTs are not the immediate priority.

C. Hemoglobin A1c and fasting glucose: These tests assess long-term and short-term glycemic control, which is important in diabetes management. However, they do not address the acute neuromuscular and cardiovascular symptoms the client is experiencing.

D. Complete blood count (CBC) with differential: A CBC evaluates for infection, anemia, or other hematologic issues. The client’s current symptoms do not suggest an infectious or hematologic cause; electrolyte assessment is more urgent to guide immediate intervention.

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Free Nursing Study Resources

Correct Answer is ["B","F","G","H"]

Explanation

Rationale:

A. Jaundice of sclera: Persistence of jaundice indicates ongoing hyperbilirubinemia and liver dysfunction. This finding does not suggest improvement or a positive response to treatment.

B. Blood pressure 136/81 mm Hg: A reduction in blood pressure from 146/91 mm Hg indicates improvement in cardiovascular stability, suggesting that interventions (e.g., fluid management, monitoring, or antihypertensive therapy) are effective.

C. Mild intermittent headaches: Headaches are nonspecific and may indicate ongoing systemic issues such as hypertension, dehydration, or metabolic imbalance. They do not reflect a clear positive response to treatment.

D. Nausea with meals: Presence of nausea is a negative symptom indicating ongoing gastrointestinal or hepatic dysfunction. Improvement would be indicated by absence of nausea.

E. Mild dyspnea with exertion: Dyspnea suggests residual respiratory or circulatory compromise. While mild, it does not clearly demonstrate a positive response to treatment.

F. 180 mL clear amber urine in 4 hours: Adequate urine output and normal coloration indicate improving renal perfusion and fluid balance, reflecting a positive response to treatment.

G. Medium bowel movement that is soft, brown: Normal bowel movements indicate gastrointestinal function is stabilizing, suggesting a positive response to care.

H. Alert and oriented to person, place, time, and situation: Full orientation reflects neurological improvement, indicating that metabolic or hepatic encephalopathy is resolving, which is a positive treatment outcome.

A. Adherence to a high fiber, low fat diet. B. Events requiring steroid dose adjustments. C. Importance of recording daily weights. D. Need to check temperature daily.

Correct Answer is B

Explanation

Rationale:
A. Adherence to a high fiber, low fat diet: Diet modifications are not the primary focus for Addison’s disease management. Nutritional adjustments may support overall health, but they do not prevent adrenal crises or manage steroid replacement therapy.

B. Events requiring steroid dose adjustments: Clients with Addison’s disease must increase glucocorticoid doses during stress, illness, surgery, or infection to prevent adrenal crisis. Teaching the client which situations require dose adjustments is essential for safe self-management and prevention of life-threatening complications.

C. Importance of recording daily weights: Daily weights are more relevant for clients with fluid balance concerns, such as heart failure. While important in some chronic illnesses, weight monitoring is not central to Addison’s disease management.

D. Need to check temperature daily: Routine temperature monitoring is not specifically required for Addison’s disease self-management unless the client is ill. Fever may indicate infection, but this is not a core self-care teaching point.

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Patient Data Based on the client’s history and clinical findings, which of the following laboratory tests should the nurse anticipate the provider will order first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["B","F","G","H"]

Explanation

The nurse is preparing an adult with Addison's disease for self-management. Which information should the nurse include in the client's instructions?

Correct Answer is B

Explanation

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Patient Data

Based on the client’s history and clinical findings, which of the following laboratory tests should the nurse anticipate the provider will order first?