The nurse is reviewing the laboratory test results of a client with long-standing hypertension. Which result would be of most concern to the nurse?
Creatinine 3.2 mg/dL
Potassium 3.4 mEq/L
Hemoglobin 12.8 g/dL
Blood urea nitrogen (BUN) 20 mg/dL
The Correct Answer is A
Choice A reason: This is the most concerning result for the nurse. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in the urine. A high creatinine level indicates impaired kidney function, which can be a complication of hypertension. The normal range of creatinine is 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women. A creatinine level of 3.2 mg/dL is more than twice the upper limit of normal and suggests severe kidney damage.
Choice B reason: This is not a concerning result for the nurse. Potassium is an electrolyte that is essential for the function of nerves and muscles, especially the heart. The normal range of potassium is 3.5 to 5.0 mEq/L. A potassium level of 3.4 mEq/L is slightly below the normal range, but not enough to cause serious problems. A low potassium level can be caused by diuretics, vomiting, diarrhea, or excessive sweating. The nurse should monitor the client's potassium level and symptoms, and advise the client to eat foods that are high in potassium, such as bananas, oranges, potatoes, and tomatoes.
Choice C reason: This is not a concerning result for the nurse. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues. The normal range of hemoglobin is 13.5 to 17.5 g/dL for men and 12.0 to 15.5 g/dL for women. A hemoglobin level of 12.8 g/dL is within the normal range for women and slightly below the normal range for men, but not enough to cause significant anemia. A low hemoglobin level can be caused by blood loss, iron deficiency, or bone marrow disorders. The nurse should assess the client's history, diet, and symptoms, and check for other signs of anemia, such as pallor, fatigue, and shortness of breath.
Choice D reason: This is not a concerning result for the nurse. Blood urea nitrogen (BUN) is a waste product of protein metabolism that is filtered by the kidneys and excreted in the urine. A high BUN level indicates impaired kidney function or dehydration. The normal range of BUN is 7 to 20 mg/dL. A BUN level of 20 mg/dL is at the upper limit of normal, but not enough to indicate serious kidney problems. The nurse should ensure that the client is well hydrated and monitor the client's urine output and specific gravity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not a correct statement. Meat and eggs mostly contain saturated fats, which are fats that have no double bonds between the carbon atoms. Saturated fats are solid at room temperature and can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should limit the intake of saturated fats to less than 10% of the total calories per day.
Choice B reason: This is not a correct statement. Coconut oil is a saturated fat, which is a fat that has no double bonds between the carbon atoms. Coconut oil is solid at room temperature and can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should avoid or limit the use of coconut oil and other sources of saturated fats.
Choice C reason: This is the correct statement. Olive oil is a monounsaturated fat, which is a fat that has one double bond between the carbon atoms. Monounsaturated fats are liquid at room temperature and can lower the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should use olive oil and other sources of monounsaturated fats instead of saturated fats.
Choice D reason: This is not a correct statement. Butter is high in saturated fats, which are fats that have no double bonds between the carbon atoms. Saturated fats are solid at room temperature and can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should avoid or limit the intake of butter and other sources of saturated fats.
Correct Answer is A
Explanation
Choice A reason: Placing the call bell in reach of the client is the most appropriate nursing action following the administration of metoprolol, a beta-blocker that lowers blood pressure and heart rate. ¹ The client may experience dizziness, lightheadedness, or fainting as side effects of the medication, especially after the first dose. ² The call bell allows the client to alert the nurse if they need assistance or experience any adverse reactions.
Choice B reason: Taking a pulse oximetry reading is not the most appropriate nursing action following the administration of metoprolol. Pulse oximetry measures the oxygen saturation of the blood, which is not directly affected by metoprolol. ³ A more relevant vital sign to monitor is the blood pressure and heart rate, which can indicate the effectiveness and safety of the medication.
Choice C reason: Recording the client's weight is not the most appropriate nursing action following the administration of metoprolol. Weight is not a sensitive indicator of the immediate effects of metoprolol. Weight may be monitored periodically to assess the client's fluid status and possible signs of heart failure, which metoprolol can help prevent. ¹ However, this is not a priority action after the first dose of the medication.
Choice D reason: Encouraging oral fluids is not the most appropriate nursing action following the administration of metoprolol. Oral fluids may help prevent dehydration and constipation, which can occur as side effects of metoprolol. ² However, excessive fluid intake may worsen the client's blood pressure and heart function, which metoprolol aims to improve. The nurse should advise the client to drink fluids as directed by the provider and report any signs of fluid overload, such as swelling, shortness of breath, or weight gain.
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