Use Case Study to answer the following questions.
Which of the following assessment findings is most concerning in a patient with hypokalemia?
Flattened T waves on ECG
Muscle cramps
Fatigue
Decreased bowel sounds
The Correct Answer is A
Rationale:
A. This is an early and potentially serious sign of cardiac involvement in hypokalemia. It can lead to life-threatening arrhythmias such as ventricular tachycardia or fibrillation. Continuous cardiac monitoring is essential in patients with low potassium levels.
B. Muscle cramps – Common in hypokalemia due to muscle cell irritability, but not immediately life-threatening like cardiac effects.
C. Fatigue is a general symptom of hypokalemia, but nonspecific and not as critical as ECG changes.
D. Decreased bowel sounds – Reflects reduced smooth muscle activity (hypokalemia can slow GI motility), but this is also less critical than cardiac dysrhythmias.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Request a potassium replacement: The client's potassium level is 3.0 mEq/L, which indicates hypokalemia (normal range: 3.5–5.0 mEq/L). TPN can cause electrolyte shifts, so potassium supplementation is appropriate and should be initiated to prevent complications like arrhythmias and muscle weakness.
B. Administer glucagon IM: This is used to treat severe hypoglycemia. The client’s glucose is 72 mg/dL, which is within the normal range (70–100 mg/dL fasting), so glucagon is not needed.
C. Check the client for a positive Chvostek's sign: Chvostek’s sign is associated with hypocalcemia, not hypokalemia, and calcium levels were not mentioned as abnormal here.
D. Discontinue the TPN infusion: Discontinuing TPN is not appropriate without a critical reason. Electrolyte imbalances are common during TPN therapy and are typically managed by adjusting the TPN formulation rather than stopping it altogether.
Correct Answer is D
Explanation
Rationale:
A. Respiratory alkalosis results from hyperventilation, which is unlikely with opioid overdose.
B. Metabolic acidosis can occur from other causes but is not the primary imbalance here.
C. Metabolic alkalosis is not associated with opioid overdose.
D. Respiratory acidosis occurs due to hypoventilation caused by opioid-induced respiratory depression, leading to CO₂ retention and decreased pH.
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