The nurse is caring for a client diagnosed with acute renal failure and has a potassium level of 8.3 mEq/L. What collaborative intervention would be a priority for this client?
Prepare the client for dialysis.
Start an IV and run normal saline at 50m/hour.
Repeat the electrolyte values later in the day
Monitor urine output
The Correct Answer is A
A. Prepare the client for dialysis: A potassium level of 8.3 mEq/L is critically high (normal range: 3.5–5.3 mEq/L), putting the client at immediate risk for life-threatening cardiac arrhythmias (e.g., ventricular fibrillation). Emergency dialysis is needed to remove excess potassium if other interventions (e.g., insulin, calcium gluconate) fail.
B. Start an IV and run normal saline at 50mL/hour: Fluid administration alone does not lower potassium quickly enough in a life-threatening situation.
C. Repeat the electrolyte values later in the day: Delaying treatment would increase the risk of cardiac arrest.
D. Monitor urine output: Although important, monitoring alone does not treat the emergency. Clients with acute renal failure often have little to no urine output.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Fluid will be pushed into the interstitial spaces. Hypertonic solutions draw water into the bloodstream, not into tissues.
B. Fluid will be pulled out of the cells and into the bloodstream: Hypertonic solutions (e.g., 3% NaCl, D10W) have a higher osmolarity than blood plasma. This pulls fluid from cells into the intravascular space, causing cell shrinkage and increasing blood volume.
C. Fluid will be pushed out of the bloodstream into extravascular spaces. This describes a hypotonic solution’s effect.
D. Fluid will be pulled out of the bloodstream into the cells. This describes an isotonic or hypotonic effect.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"C"}}
Explanation
|
Solutions |
Hypotonic |
Isotonic |
Hypertonic |
|
0.45% sodium chloride |
✅ |
||
|
0.9% sodium chloride |
✅ |
||
|
Lactated Ringers |
✅ |
||
|
Albumin |
✅ |
0.45% Sodium Chloride (Hypotonic): Has lower osmolarity than blood, causing fluid to shift into cells, making them swell. Used for dehydration and intracellular rehydration.
0.9% Sodium Chloride (Isotonic): Has the same osmolarity as blood, so it stays in the intravascular space. Used for fluid resuscitation (hypovolemia, dehydration, shock).
Lactated Ringers (Isotonic): Contains electrolytes (Na+, K+, Ca2+, lactate), making it ideal for burns, surgery, and trauma patients. Maintains intravascular volume without fluid shifts.
Albumin (Hypertonic): Large protein that pulls fluid into the intravascular space (colloid osmotic pressure). Used for hypovolemia, burns, or severe hypoalbuminemia.
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