The nurse is caring for the following clients. Which client should the nurse assess first?

A 60-year-old client who has end-stage renal disease with a creatinine of 5.1

A 50-year-old client who has chronic pancreatitis and is reporting a pain level of 6 out of 10

A 54-year-old client with cirrhosis and jaundice who is reporting itchiness and drowsiness

A 47-year-old client with esophageal varices and influenza and has been coughing for 30 minutes

Answer and Explanation

The Correct Answer is D

Choice A reason: Creatinine 5.1 in ESRD is chronic, not acute, and stable unless symptomatic; it’s less urgent than potential bleeding risks in other clients.

Choice B reason: Pain (6/10) in pancreatitis is significant but not immediately life-threatening compared to airway or bleeding risks, manageable with scheduled interventions.

Choice C reason: Itchiness and drowsiness in cirrhosis suggest liver dysfunction, concerning but not acute threats like variceal rupture, prioritizing more critical symptoms.

Choice D reason: Coughing with esophageal varices risks rupture and massive bleeding, a life-threatening emergency, making this client the priority for immediate assessment.

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Correct Answer is B

Explanation

Choice A reason: 1 tablet (50 mcg) provides half the 100 mcg dose, insufficient for hypothyroidism treatment, underdosing the required thyroid hormone replacement level.

Choice B reason: 2 tablets (50 mcg each) equal 100 mcg, matching the prescribed dose, ensuring adequate T4 replacement for hypothyroidism’s metabolic needs daily.

Choice C reason: 3 tablets (150 mcg) exceed the 100 mcg dose, risking hyperthyroidism symptoms like tachycardia or nervousness from excessive thyroid hormone administration.

Choice D reason: 4 tablets (200 mcg) grossly overdose the 100 mcg requirement, potentially causing severe thyrotoxicosis, disrupting metabolism and cardiac function dangerously.

A. Fluid restriction B. Neomycin C. Kayexalate D. Sodium chloride infusion and furosemide

Correct Answer is C

Explanation

Choice A reason: Fluid restriction doesn’t address hyperkalemia (6.4 mEq/L); it may concentrate potassium further, worsening the condition, as it’s unrelated to potassium excretion or shifting in this scenario.

Choice B reason: Neomycin, an antibiotic, reduces gut bacteria but isn’t used for hyperkalemia. It has no direct effect on potassium levels, making it irrelevant for this lab finding.

Choice C reason: Kayexalate binds potassium in the gut, facilitating its fecal excretion, effectively lowering serum levels (6.4 mEq/L) in hyperkalemia, aligning with urgent correction needs here.

Choice D reason: Sodium chloride and furosemide dilute and excrete potassium via urine, but Kayexalate is preferred for rapid gut-based removal when potassium is critically high (6.4 mEq/L).

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The nurse is caring for the following clients. Which client should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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