The nurse practitioner is reviewing laboratory results for a 65-year-old man with a history of diabetes mellitus and heart failure. His most recent potassium (K⁺) level is 5.5 mEq/L. Which of the following is the next appropriate step?
Do nothing; this is an expected finding.
Call this patient and have him go to the local hospital to be admitted.
Have him come into the office for intravenous (IV) fluids, then recheck his potassium level.
Have him come into the office for an electrocardiogram, then decide whether he needs to be admitted.
The Correct Answer is D
Choice A reason: A potassium level of 5.5 mEq/L is mildly elevated and not within the normal range. Doing nothing would be inappropriate, especially in a patient with heart failure, where hyperkalemia can precipitate arrhythmias.
Choice B reason: Immediate hospital admission is not warranted for a potassium level of 5.5 mEq/L unless there are ECG changes or symptoms of hyperkalemia. This step would be premature without further assessment.
Choice C reason: IV fluids are not the first-line treatment for mild hyperkalemia unless there is volume depletion or renal impairment. Rechecking potassium without assessing cardiac status could miss potentially dangerous arrhythmias.
Choice D reason: An electrocardiogram (ECG) is the appropriate next step to assess for cardiac effects of hyperkalemia. ECG changes such as peaked T waves or widened QRS complexes would guide further management, including possible hospital admission or urgent treatment. This approach balances safety and clinical judgment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This describes the pathophysiology of chronic bronchitis, a form of chronic obstructive pulmonary disease (COPD), not bacterial pneumonia. It involves inflammation of the bronchial walls and mucosal changes but does not explain the alveolar involvement seen in pneumonia.
Choice B reason: This is characteristic of emphysema, another form of COPD, where alveolar walls are destroyed leading to air trapping and reduced gas exchange. It is not the mechanism of bacterial pneumonia.
Choice C reason: This describes asthma, where airway obstruction results from smooth muscle contraction, mucus production, and inflammation. Pneumonia does not typically involve bronchospasm or reversible airway obstruction.
Choice D reason: This accurately describes bacterial pneumonia. The infection triggers an inflammatory response that increases permeability of the alveolar-capillary membrane, leading to fluid accumulation, impaired gas exchange, and reduced lung compliance. This results in symptoms such as dyspnea, cough, and hypoxia.
Correct Answer is C
Explanation
Choice A reason: Advanced sleep phase type is characterized by falling asleep and waking up earlier than desired. Individuals with this disorder tend to feel sleepy in the early evening and wake up very early in the morning, which is the opposite of the scenario described.
Choice B reason: Irregular sleep-wake type involves a lack of a clearly defined sleep-wake cycle. People with this disorder have fragmented sleep patterns with multiple naps throughout the 24-hour period, not a consistent delay in sleep and wake times.
Choice C reason: Delayed sleep phase type is defined by a consistent pattern of falling asleep and waking up later than desired. This disorder is common in adolescents and young adults and matches the client’s report of delayed sleep onset and waking.
Choice D reason: Non-24 sleep-wake type is typically seen in individuals who are blind and lack light perception. Their circadian rhythm does not align with the 24-hour day, leading to progressively shifting sleep times. This does not match the client’s stable but delayed sleep pattern.
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