Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is assessing a client who has hypermagnesemia.
Which of the following medications should the nurse prepare to administer?
A. Calcium gluconate.
Calcium gluconate is used to treat hypermagnesemia because it can help calm some symptoms such as impaired breathing, irregular heartbeat, and hypotension. Calcium also helps normalize the neuromuscular function that is affected by excess magnesium.
B. Acetylcysteine.
Acetylcysteine is wrong because it is used to treat acetaminophen overdose and prevent kidney damage from contrast dye. It has no role in treating hypermagnesemia.
C. Flumazenil.
Flumazenil is wrong because it is used to reverse the effects of benzodiazepines, a class of sedative drugs. It has no role in treating hypermagnesemia.
D. Protamine sulfate.
Protamine sulfate is wrong because it is used to reverse the effects of heparin, an anticoagulant drug. It has no role in treating hypermagnesemia. Normal ranges for magnesium are 1.7 to 2.3 mg/dL or 0.7 to 1.1 mmol/L. Hypermagnesemia is defined as a magnesium level above 2.6 mg/dL or 1.5 mmol/L.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
Calcium gluconate is used to treat hypermagnesemia because it can help calm some symptoms such as impaired breathing, irregular heartbeat, and hypotension. Calcium also helps normalize the neuromuscular function that is affected by excess magnesium.
Choice B. Acetylcysteine is wrong because it is used to treat acetaminophen overdose and prevent kidney damage from contrast dye.
It has no role in treating hypermagnesemia.
Choice C. Flumazenil is wrong because it is used to reverse the effects of benzodiazepines, a class of sedative drugs.
It has no role in treating hypermagnesemia.
Choice D. Protamine sulfate is wrong because it is used to reverse the effects of heparin, an anticoagulant drug.
It has no role in treating hypermagnesemia.
Normal ranges for magnesium are 1.7 to 2.3 mg/dL or 0.7 to 1.1 mmol/L. Hypermagnesemia is defined as a magnesium level above 2.6 mg/dL or 1.5 mmol/L.
Similar Questions
A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine.
Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine?
A. Shellfish.
Choice A is wrong because shellfish is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
B. Eggs.
According to the CDC, people with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. However, people with egg allergy can get a flu vaccine. The CDC also states that people who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. Therefore, a nurse should report an egg allergy to the provider as a possible contraindication to receiving the vaccine.
C. Milk.
Choice C is wrong because milk is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
D. Peanuts.
Choice D is wrong because peanuts are not an ingredient in a flu vaccine and are not a contraindication to receiving the vaccine.
Full Explanation
According to the CDC, people with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. However, people with egg allergy can get a flu vaccine. The CDC also states that people who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. Therefore, a nurse should report an egg allergy to the provider as a possible contraindication to receiving the vaccine.
Choice A is wrong because shellfish is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
Choice C is wrong because milk is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
Choice D is wrong because peanuts are not an ingredient in a flu vaccine and are not a contraindication to receiving the vaccine.
A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissues surrounding the insertion site. Which of the following actions should the nurse take?
A. Apply pressure to the IV site.
Choice A is wrong because applying pressure to the IV site can increase the risk of tissue damage and infection. Pressure can also obstruct blood flow and cause thrombophlebitis.
B. Elevate the extremity.
This will help reduce swelling and discomfort caused by the infiltration of fluid into the tissues. Elevating the extremity also promotes venous return and prevents further fluid accumulation.
C. Slow the infusion rate.
Choice C is wrong because slowing the infusion rate will not stop the infiltration of fluid into the tissues. Slowing the infusion rate can also delay the delivery of medication or fluid to the client.
D. Flush the IV catheter.
Choice D is wrong because flushing the IV catheter can worsen the infiltration of fluid into the tissues. Flushing the IV catheter can also introduce air or bacteria into the bloodstream and cause complications. Normal ranges for peripheral IV infusion are dependent on the type and volume of fluid, the size and location of the catheter, and the condition of the client. Generally, peripheral IV infusion rates should not exceed 100 mL/hr for adults and 60 mL/hr for children.
Full Explanation
This will help reduce swelling and discomfort caused by the infiltration of fluid into the tissues. Elevating the extremity also promotes venous return and prevents further fluid accumulation.
Choice A is wrong because applying pressure to the IV site can increase the risk of tissue damage and infection.
Pressure can also obstruct blood flow and cause thrombophlebitis.
Choice C is wrong because slowing the infusion rate will not stop the infiltration of fluid into the tissues.
Slowing the infusion rate can also delay the delivery of medication or fluid to the client.
Choice D is wrong because flushing the IV catheter can worsen the infiltration of fluid into the tissues.
Flushing the IV catheter can also introduce air or bacteria into the bloodstream and cause complications.
Normal ranges for peripheral IV infusion are dependent on the type and volume of fluid, the size and location of the catheter, and the condition of the client. Generally, peripheral IV infusion rates should not exceed 100 mL/hr for adults and 60 mL/hr for children.
A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 Ib) since the last visit 2 days ago.
Which of the following actions should the nurse take first?
A. Teach the client about foods low in sodium.
Choice A is wrong because teaching the client about foods low in sodium is not the first action the nurse should take. While a low-sodium diet is important for heart failure patients, it is not an urgent intervention and it does not address the immediate problem of fluid overload.
B. Determine medication adherence by the client.
Choice B is wrong because determining medication adherence by the client is not the first action the nurse should take. While it is important to assess if the client is taking furosemide as prescribed, it is not an urgent intervention and it does not rule out other causes of fluid retention, such as renal impairment or disease progression.
C. Encourage the client to dangle the legs while sitting in a chair.
Choice C is wrong because encouraging the client to dangle the legs while sitting in a chair is not the first action the nurse should take. While this may help reduce edema in the lower extremities, it does not address the underlying cause of fluid overload and it may worsen pulmonary congestion by increasing venous return to the heart.
D. Notify the provider of the client’s weight gain.
This is because a weight gain of 2.5 kg (5 Ib) in 2 days indicates a worsening of heart failure and fluid retention, which may require an adjustment of the diuretic dose or other medications.
Full Explanation
This is because a weight gain of 2.5 kg (5 Ib) in 2 days indicates a worsening of heart failure and fluid retention, which may require an adjustment of the diuretic dose or other medications.
The provider should be informed of this change as soon as possible to prevent further complications.
Choice A is wrong because teaching the client about foods low in sodium is not the first action the nurse should take.
While a low-sodium diet is important for heart failure patients, it is not an urgent intervention and it does not address the immediate problem of fluid overload.
Choice B is wrong because determining medication adherence by the client is not the first action the nurse should take.
While it is important to assess if the client is taking furosemide as prescribed, it is not an urgent intervention and it does not rule out other causes of fluid retention, such as renal impairment or disease progression.
Choice C is wrong because encouraging the client to dangle the legs while sitting in a chair is not the first action the nurse should take.
While this may help reduce edema in the lower extremities, it does not address the underlying cause of fluid overload and it may worsen pulmonary congestion by increasing venous return to the heart.