Which electrolyte imbalance should a nurse expect to assess in a client who reports diarrhea for the past three days?

Hypokalemia.

Hypocalcemia.

Hyponatremia.

Hypochloremia.

Answer and Explanation

The Correct Answer is A

This is because diarrhea can cause a loss of potassium along with water and other electrolytes. Potassium is an important mineral that helps regulate the heartbeat, nerve impulses and muscle contractions. Low levels of potassium can cause symptoms such as weakness, fatigue, muscle cramps, irregular heartbeat and constipation.

Choice B. Hypocalcemia is wrong because diarrhea does not usually cause a loss of

calcium. Calcium is another mineral that helps with muscle and nerve function, blood clotting and bone health. Low levels of calcium can cause symptoms such as numbness, tingling, muscle spasms, seizures and confusion.

Choice C. Hyponatremia is wrong because diarrhea can cause a loss of sodium, but not to the extent that it causes hyponatremia. Sodium is the most abundant electrolyte in the body and it helps regulate fluid balance, blood pressure and nerve and muscle function. Low levels of sodium can cause symptoms such as headache, confusion, nausea, vomiting, seizures and coma.

Choice D. Hypochloremia is wrong because diarrhea can cause a loss of chloride, but not to the extent that it causes hypochloremia. Chloride is another electrolyte that helps maintain fluid balance, blood pressure and acid-base balance. Low levels of chloride can cause symptoms such as weakness, dehydration, alkalosis (high blood pH) and muscle twitching.

The normal ranges for electrolytes in the blood are:

Potassium: 3.5 to 5 mEq/L
Calcium: 8.5 to 10.2 mg/dL
Sodium: 135 to 145 mEq/L
Chloride: 96 to 106

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Correct Answer is C

Explanation

The nurse refuses to care for someone who reminds her of a family member after interviewing the client upon admission. This action is not appropriate in the prevention of liability because it violates the client’s right to receive care and may be considered as discrimination or abandonment. The nurse has a duty to provide care to all clients regardless of their personal feelings or preferences.

Choice A is wrong because establishing rapport with the client in an inpatient psychiatric setting is an appropriate action to prevent liability. It helps to build trust and communication between the nurse and the client and reduces the risk of misunderstanding or conflict.

Choice B is wrong because documenting accurately and honestly in the electronic health record is an appropriate action to prevent liability. It provides evidence of the care provided, the client’s condition and response, and any incidents or complications that occurred.

Choice D is wrong because referring to the policy of the inpatient psychiatric setting when uncertain of a standard of care is an appropriate action to prevent liability. It helps the nurse to follow the best practices and guidelines for providing safe and effective care to the client.

A. Offering the client a bedpan every three hours. B. Keeping an emesis basin near the bedside. C. Providing oral care every four hours. D. Changing the bed linens frequently.

Correct Answer is D

Explanation

This is because a client who has been diaphoretic for the past six hours is likely to have wet and uncomfortable bed linens that can cause skin breakdown and infection. Changing the bed linens frequently can help keep the client dry and comfortable.

Choice A is wrong because offering the client a bedpan every three hours is not related to diaphoresis.

The client may or may not need to use the bedpan depending on their fluid intake and output.

Choice B is wrong because keeping an emesis basin near the bedside is not related to diaphoresis.

The client may or may not need to vomit depending on their underlying condition.

Choice C is wrong because providing oral care every four hours is not enough for a client who has been diaphoretic for the past six hours. The client may have dry mouth and dehydration due to excessive sweating and may need more frequent oral care and hydration.

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Which electrolyte imbalance should a nurse expect to assess in a client who reports diarrhea for the past three days?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse takes actions to avoid liability when caring for a client with a psychiatric disorder. Which action is not appropriate in the prevention of liability?

Correct Answer is C

Explanation

Which intervention should the nurse include while caring for a client who has been diaphoretic for the past six hours?

Correct Answer is D

Explanation

A nurse is developing a plan of care for a client diagnosed with constipation. Which nursing interventions should be included in planning? (Select all that apply).

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