Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate. If this medication is effective, the nurse should expect which of the following changes on the client's ECG?
A. Restoration of QRS Complex amplitude.
The amplitude of the QRS complex is not directly affected by changes in serum potassium levels. It represents ventricular depolarization, and its restoration would not be an expected outcome of polystyrene sulfonate treatment
B. Shortening of P-wave duration.
Shortening of the P-wave duration is not an expected change with polystyrene sulfonate treatment. The P-wave represents atrial depolarization, which is not significantly impacted by the administration of this medication
C. Widening of the QRS complex.
Widening of the QRS complex is associated with high serum potassium levels. The goal of polystyrene sulfonate treatment is to lower potassium levels and, thus, return the QRS complex to its normal width
D. Reduction of T-wave amplitude.
Polystyrene sulfonate aims to reduce serum potassium levels. When effective, this should result in a reduction of T-wave amplitude, which is a common ECG change seen with hyperkalemia In conclusion, choice D is the correct answer, as a reduction in T-wave amplitude would be the expected change on the client's ECG if polystyrene sulfonate effectively lowers their serum potassium level.
This question is an excerpt from Nurse Dive's nursing test bank - ATI custom Fluid and Electrolyte Exam Summer 2023 Proctored Exam. Take the full exam now
Full Explanation
The correct answer is choice D: Reduction of T-wave amplitude.
Choice A rationale:
The amplitude of the QRS complex is not directly affected by changes in serum potassium levels. It represents ventricular depolarization, and its restoration would not be an expected outcome of polystyrene sulfonate treatment
Choice B rationale:
Shortening of the P-wave duration is not an expected change with polystyrene sulfonate treatment. The P-wave represents atrial depolarization, which is not significantly impacted by the administration of this medication
Choice C rationale:
Widening of the QRS complex is associated with high serum potassium levels. The goal of polystyrene sulfonate treatment is to lower potassium levels and, thus, return the QRS complex to its normal width
Choice D rationale:
Polystyrene sulfonate aims to reduce serum potassium levels. When effective, this should result in a reduction of T-wave amplitude, which is a common ECG change seen with hyperkalemia
In conclusion, choice D is the correct answer, as a reduction in T-wave amplitude would be the expected change on the client's ECG if polystyrene sulfonate effectively lowers their serum potassium level.
Similar Questions
A patient recovering from surgery has an indwelling urinary catheter. For which 24-hour urine output volumes should the nurse notify the patient's healthcare provider?
A. 1000 milliliters.
A 24-hour urine output of 1000 milliliters is within the normal range for an adult, indicating adequate kidney function and hydration.
B. 600 milliliters.
A 24-hour urine output of 600 milliliters is below the normal range (typically 800-2000 milliliters), which may indicate oliguria (reduced urine output) and could be a sign of renal impairment or dehydration. This warrants notifying the healthcare provider.
C. 1200 milliliters.
A 24-hour urine output of 1200 milliliters is also within the normal range, suggesting normal kidney function and hydration status.
D. 750 milliliters.
A 24-hour urine output of 750 milliliters is slightly below the normal range but may not be immediately concerning unless accompanied by other symptoms. However, it is still important to monitor and possibly notify the healthcare provider if it persists.
Full Explanation
The correct answer is B. 600 milliliters.
Choice A rationale:
A 24-hour urine output of 1000 milliliters is within the normal range for an adult, indicating adequate kidney function and hydration.
Choice B rationale:
A 24-hour urine output of 600 milliliters is below the normal range (typically 800-2000 milliliters), which may indicate oliguria (reduced urine output) and could be a sign of renal impairment or dehydration. This warrants notifying the healthcare provider.
Choice C rationale:
A 24-hour urine output of 1200 milliliters is also within the normal range, suggesting normal kidney function and hydration status.
Choice D rationale:
A 24-hour urine output of 750 milliliters is slightly below the normal range but may not be immediately concerning unless accompanied by other symptoms. However, it is still important to monitor and possibly notify the healthcare provider if it persists.
The nurse is admitting a patient who was diagnosed with acute renal failure. Which electrolyte should the nurse expect to be most affected with this disorder?
A. Phosphorous.
While acute renal failure can affect phosphorus levels, potassium is the electrolyte most commonly affected in this condition. Kidneys play a crucial role in regulating potassium levels in the body, and when they fail, potassium levels can become dangerously elevated.
B. Magnesium.
Acute renal failure can lead to alterations in magnesium levels, but potassium is typically more affected. Magnesium imbalances may occur but are not the primary concern in this condition.
C. Potassium.
As mentioned earlier, potassium imbalances are common in acute renal failure. The nurse should closely monitor the patient's potassium levels and be prepared to intervene if they become too high or too low.
D. Calcium.
Calcium levels may also be affected in acute renal failure, but potassium remains the most critical electrolyte to monitor in this condition.
Full Explanation
Choice A rationale:
While acute renal failure can affect phosphorus levels, potassium is the electrolyte most commonly affected in this condition. Kidneys play a crucial role in regulating potassium levels in the body, and when they fail, potassium levels can become dangerously elevated.
Choice B rationale:
Acute renal failure can lead to alterations in magnesium levels, but potassium is typically more affected. Magnesium imbalances may occur but are not the primary concern in this condition.
Choice C rationale:
As mentioned earlier, potassium imbalances are common in acute renal failure. The nurse should closely monitor the patient's potassium levels and be prepared to intervene if they become too high or too low.
Choice D rationale:
Calcium levels may also be affected in acute renal failure, but potassium remains the most critical electrolyte to monitor in this condition.
A nurse is reviewing a client's laboratory values and discovers the client has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate?
A. Administering a potassium-sparing diuretic.
Administering a potassium-sparing diuretic is not appropriate for a client with hyperkalemia (high potassium levels). Potassium-sparing diuretics would further increase potassium levels, worsening the condition.
B. Administering sodium polystyrene sulfonate.
Sodium polystyrene sulfonate is used to treat hyperkalemia. It works by exchanging sodium ions for potassium ions in the intestines, which helps to lower serum potassium levels by excreting it through the stool.
C. Initiating an IV potassium infusion.
Initiating an IV potassium infusion would be contraindicated in this situation as it would increase the already elevated potassium levels, potentially leading to dangerous cardiac complications.
D. Encouraging the client to eat bananas.
Encouraging the client to eat bananas is not advisable because bananas are high in potassium, which would exacerbate hyperkalemia.
Full Explanation
The correct answer is choice B) Administering sodium polystyrene sulfonate.
Choice A rationale:
Administering a potassium-sparing diuretic is not appropriate for a client with hyperkalemia (high potassium levels). Potassium-sparing diuretics would further increase potassium levels, worsening the condition.
Choice B rationale:
Sodium polystyrene sulfonate is used to treat hyperkalemia. It works by exchanging sodium ions for potassium ions in the intestines, which helps to lower serum potassium levels by excreting it through the stool.
Choice C rationale:
Initiating an IV potassium infusion would be contraindicated in this situation as it would increase the already elevated potassium levels, potentially leading to dangerous cardiac complications.
Choice D rationale:
Encouraging the client to eat bananas is not advisable because bananas are high in potassium, which would exacerbate hyperkalemia.