Urinary Elimination NCLEX RN Questions
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Question 1 of 5.
The nurse is caring for an assigned client. Which prescription requires clarification based on the laboratory data? See the exhibit. Select all that apply. Prescribed Medications: vancomycin 1-gram IVPB daily, furosemide 40 mg PO daily, 500 mL of 0.9% sodium chloride bolus x 1 dose, diltiazem XR 120 mg PO daily, Ketorolac 15 mg IV push every eight hours PRN pain. Laboratory Results: Sodium 145 mEq/L (145 mmol/L), Potassium 3.7 mEq/L (3.7 mmol/L), Calcium 9.3 mg/dL (2.32 mmol/L), BUN 25 mg/dL (8.93 mmol/L), Creatinine 2.1 mg/dL (185.64 umol/L)
A. vancomycin 1-gram IVPB Daily
B. furosemide 40 mg PO Daily
C. 500 ml of 0.9% Saline IV Bolus x 1
D. diltiazem XR 120 mg PO Daily
E. ketorolac 15 mg IV Q 8 hours
Explanation: Vancomycin (A) and Ketorolac (E) require clarification due to the elevated creatinine (2.1 mg/dL), indicating impaired renal function, which can increase the risk of toxicity for both drugs. Furosemide (B), saline bolus (C), and diltiazem (D) are not contraindicated with the given lab results.
Question 2 of 5.
The nurse reviews the lab values of a client and notes a serum sodium level of 125 mEq/L (mmol/L) [Reference range: 135-145 mEq/L (mmol/L)]. Which conditions does the nurse recognize as potential causes of this laboratory abnormality? Select all that apply.
A. syndrome of inappropriate antidiuretic hormone (SIADH)
B. diabetes Insipidus
C. addison's disease (adrenal insufficiency)
D. psychogenic polydipsia
E. salt water drowning
Explanation: SIADH causes water retention, diluting sodium. Addison's disease reduces aldosterone, leading to sodium loss. Psychogenic polydipsia causes excessive water intake, diluting sodium.
Question 3 of 5.
The nurse is caring for a client on a medical floor. The nurse would recognize that which diagnosis increases the client's risk of developing hyperkalemia?
A. Cushing's syndrome
B. Acute renal failure
C. Cystic fibrosis
D. Bulimia nervosa
Explanation: Acute renal failure impairs potassium excretion, leading to hyperkalemia.
Question 4 of 5.
The nurse is reviewing labs for a client with a serum potassium level of 3.3 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. The nurse should take which essential action based on this laboratory result?
A. Educate the client on potassium-rich foods
B. Implement continuous telemetry monitoring
C. Obtain an order for calcium gluconate
D. Assess the client's neurological status
Explanation: Hypokalemia (low potassium) requires dietary education to increase potassium intake, as it does not typically necessitate telemetry or calcium.
Question 5 of 5.
The nurse is reviewing the laboratory results of a client with renal failure. Which laboratory data requires immediate follow-up?
A. Blood urea nitrogen 50 mg/dL [10-20 mg/dL]
B. Serum potassium 6 mEq/L (mmol/L) [3.5-5.0 mEq/L]
C. Arterial blood pH 7.30 [7.35-7.45]
D. Hemoglobin 10.3 g/dL (1.03 g/L) [F: 12-16 g/dL (7.4 -9.9 mmol/L) M: 14-18 g/dL (8,7-11.2 mmol/L)]
Explanation: Hyperkalemia (6 mEq/L) requires immediate follow-up due to the risk of cardiac dysrhythmias.
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