Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?
- Glucose [Reference Range: 74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
- Hemoglobin (Hgb) [Reference Range:12-16 g/dL (120-160 g/L)]
- Potassium (K+) [Reference Range: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
- Ammonia [Reference Range: Adult: 10 to 80 Mcg/dL (6 to 47 Mcmol/dL)]
A. Serum ammonia level of 30 Mcg/dL (17.62 Mcmol /dL).
Serum ammonia levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
B. Serum potassium level of 3.8 mEq/L (3.8 mmol/L).
Sodium polystyrene sulfonate is a medication used to treat hyperkalemia (high potassium levels). A serum potassium level of 3.8 mEq/L falls within the normal reference range (3.5 to 5.0 mEq/L), indicating that the medication has been effective in promoting the excretion of potassium and reducing hyperkalemia.
C. Serum glucose level of 120 mg/dL (6.7 mmol/L).
Serum glucose levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
D. Hemoglobin level of 13.5 g/dL (135 g/L).
Hemoglobin levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
This question is an excerpt from Nurse Dive's nursing test bank - Hesi Pharmacology Proctored Exam 2. Take the full exam now
Full Explanation
Choice A rationale: Serum ammonia levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Choice B rationale: Sodium polystyrene sulfonate is a medication used to treat hyperkalemia (high potassium levels). A serum potassium level of 3.8 mEq/L falls within the normal reference range (3.5 to 5.0 mEq/L), indicating that the medication has been effective in promoting the excretion of potassium and reducing hyperkalemia.
Choice C rationale: Serum glucose levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Choice D rationale: Hemoglobin levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Similar Questions
The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse report to the healthcare provider?
A. Hematemesis.
Hematemesis refers to the vomiting of blood and is a severe and potentially life-threatening adverse effect of ibuprofen. Ibuprofen belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs), which can cause gastrointestinal bleeding and ulcerations. Hematemesis indicates significant gastrointestinal irritation or bleeding, and it requires immediate attention from the healthcare provider to assess and manage the client's condition.
B. Nausea.
Nausea is a common side effect of ibuprofen and other NSAIDs. While it is important to monitor and address any adverse effects experienced by the client, nausea alone is not as urgent or critical as hematemesis, which can indicate a more severe complication.
C. Insomnia.
Insomnia is not directly related to the use of ibuprofen. While sleep disturbances can occur as a side effect of some medications, it is not the most important finding to report to the healthcare provider in this context.
D. Dizziness.
Dizziness can be a side effect of ibuprofen, but it is not the most concerning finding in this situation. Hematemesis, which indicates potential gastrointestinal bleeding, is a more critical symptom that requires immediate attention and reporting to the healthcare provider.
Full Explanation
Choice A rationale: Hematemesis refers to the vomiting of blood and is a severe and potentially life-threatening adverse effect of ibuprofen. Ibuprofen belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs), which can cause gastrointestinal bleeding and ulcerations.
Hematemesis indicates significant gastrointestinal irritation or bleeding, and it requires immediate attention from the healthcare provider to assess and manage the client's condition.
Choice B rationale: Nausea is a common side effect of ibuprofen and other NSAIDs. While it is important to monitor and address any adverse effects experienced by the client, nausea alone is not as urgent or critical as hematemesis, which can indicate a more severe complication.
Choice C rationale: Insomnia is not directly related to the use of ibuprofen. While sleep disturbances can occur as a side effect of some medications, it is not the most important finding to report to the healthcare provider in this context.
Choice D rationale: Dizziness can be a side effect of ibuprofen, but it is not the most concerning finding in this situation. Hematemesis, which indicates potential gastrointestinal bleeding, is a more critical symptom that requires immediate attention and reporting to the healthcare provider.
After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?
A. Instruct the client to increase her intake of saturated fats over the next week.
This option is not appropriate as increasing saturated fat intake would exacerbate the oily stool and flatus symptoms caused by orlistat. Orlistat is specifically designed to reduce fat absorption, and increasing fat intake would be counterproductive and may worsen the side effects.
B. Ask the client to describe her dietary intake history for the last several days.
While it is important to assess the client's dietary intake history, it may not provide specific insights into the cause of the oily stools and flatus. These symptoms are well- known side effects of orlistat, and it is not necessary to gather dietary history information to confirm this. Instead, the focus should be on addressing the side effects and discussing the continuation of the medication with the healthcare provider.
C. Advise the client to stop taking the drug and contact her healthcare provider.
The client is experiencing increasingly frequent oily stools and flatus, which are common side effects of orlistat. Orlistat is a medication used to aid weight loss by inhibiting the absorption of dietary fats in the intestines. By blocking the enzyme responsible for breaking down fats, orlistat prevents the absorption of a portion of the dietary fat, leading to increased fat content in the stool.
D. Obtain a stool specimen to evaluate for occult blood and fat content.
While obtaining a stool specimen for evaluation might be relevant in some situations, it is not the priority in this case. The oily stools and flatus are most likely related to the side effects of orlistat and do not typically require stool testing for confirmation. The more immediate action would be to address the symptoms by advising the client to stop taking the medication and contact her healthcare provider for further guidance.
Full Explanation
Choice A rationale: This option is not appropriate as increasing saturated fat intake would exacerbate the oily stool and flatus symptoms caused by orlistat. Orlistat is specifically designed to reduce fat absorption, and increasing fat intake would be counterproductive and may worsen the side effects.
Choice B rationale: Asking a client to describe their dietary intake history is a standard practice in nutritional assessment. It provides a baseline for understanding current eating habits and identifying areas for improvement.
Choice C rationale: Advising a client to stop taking medication should only be done by a qualified healthcare provider who has full knowledge of the client's health history and current medications.
Choice D rationale: While obtaining a stool specimen for evaluation might be relevant in some situations, it is not the priority in this case. The oily stools and flatus are most likely related to the side effects of orlistat and do not typically require stool testing for confirmation. The more immediate action would be to address the symptoms by advising the client to stop taking the medication and contact her healthcare provider for further guidance.
An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions?
A. Bedtime is the best time to take the tablet.
Taking ferrous sulfate at bedtime does not have a significant impact on its absorption. The critical factor is to take it on an empty stomach to maximize absorption, not necessarily at a specific time of day.
B. Crush the tablets and mix with pudding.
Enteric-coated tablets are specifically designed to dissolve in the small intestine and not in the stomach. Crushing them would destroy the enteric coating, leading to iron being released in the stomach, which can cause gastric irritation and reduce iron absorption.
C. Wait 2 hours after meals to take the tablet.
Iron absorption is influenced by food intake. Taking ferrous sulfate on an empty stomach (at least 1 hour before or 2 hours after meals) enhances its absorption. When taken with food, especially foods containing calcium, the absorption of iron can be significantly reduced. Therefore, it is essential to instruct the client to wait at least 2 hours after meals before taking the enteric-coated tablets to optimize iron absorption.
D. Take the tablet with a daily multivitamin.
Taking ferrous sulfate with a multivitamin may not be ideal for iron absorption. Some multivitamins contain calcium or other minerals that can inhibit iron absorption. To maximize iron absorption, it is best to take ferrous sulfate on an empty stomach, as mentioned in option C.
Full Explanation
A. Bedtime is the best time to take the tablet. While taking medication at bedtime can sometimes be convenient, it is not necessarily the best time for iron absorption. Iron is best absorbed on an empty stomach, and bedtime might not always align with this condition.
B. Crush the tablets and mix with pudding. Crushing enteric-coated tablets is not recommended because it destroys the coating designed to protect the stomach lining from irritation and to ensure the iron is released in the intestine where it is best absorbed.
C. Wait 2 hours after meals to take the tablet. This is the correct answer because iron is best absorbed on an empty stomach, typically one hour before or two hours after meals. Food can interfere with the absorption of iron, so waiting ensures better efficacy of the supplement.
D. Take the tablet with a daily multivitamin.Taking iron with a multivitamin can be problematic because certain minerals in multivitamins, such as calcium, can inhibit iron absorption. It is better to take iron supplements separately to maximize absorption.