Question

A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?

Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

Answer 1

Correct Answers:

Sodium polystyrene sulfonate 15 grams by mouth.

Rationale :

🔷 The client's potassium level (6.7 mEq/L) indicates severe hyperkalemia, which poses a risk for fatal cardiac dysrhythmias.

🔷 Sodium polystyrene sulfonate works by binding potassium in the GI tract and promoting its excretion.

🔷 This medication is indicated first-line in emergency situations involving high potassium levels.

🔷 Immediate correction of hyperkalemia is a critical priority in acute renal injury.

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Answer 2

Correct Answers:

Serum creatinine of 1.9 mg/dL (169 umol/L).

Rationale :

🔶 A serum creatinine of 1.9 mg/dL indicates impaired kidney function, above the normal reference range.

🔶 MRI contrast agents can be nephrotoxic, and administering them without precaution may worsen kidney injury.

🔶 The nurse should report elevated creatinine before the scan to assess the safety of contrast use.

🔶 Renal function must be evaluated prior to contrast administration in older adults.

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Answer 3

Correct Answers:

Expect the insulin dosage to be reduced.

Rationale :

💠 Hemodialysis can improve insulin sensitivity, increasing the risk of hypoglycemia if insulin is not adjusted.

💠 The kidneys play a role in insulin metabolism; reduced function alters insulin clearance.

💠 Educating the client on this change helps prevent complications during dialysis initiation.

💠 Blood glucose monitoring should be increased when starting dialysis.

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Answer 4

Correct Answers:

Pupillary changes to ipsilateral dilation.

Rationale :

💎 A dilated pupil on the affected side may indicate increased intracranial pressure or brain herniation.

💎 This is an emergency neuro sign requiring rapid intervention to prevent irreversible brain injury.

💎 Compression of cranial nerve III (oculomotor) often causes ipsilateral pupil dilation.

💎 It signals worsening neurologic status in stroke or head trauma patients.

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Answer 5

Correct Answers:

Begin preparing the client for discharge home.

Rationale :

✴ The client has moist mucous membranes, stable BP, and intact peripheral pulses, indicating good hydration and perfusion.

✴ Verbalizing the importance of daily medication compliance shows understanding of the condition.

✴ There are no signs of adrenal crisis, which suggests stability.

✴ These findings support safe discharge planning.

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Answer 6

Correct Answers:

Gastroccult positive emesis.

Rationale :

✔ A positive gastroccult indicates upper GI bleeding, a serious complication post-bariatric surgery.

✔ This could be due to marginal ulcers or anastomotic erosion after BPD.

✔ Prompt evaluation and intervention are needed to prevent hypovolemia or perforation.

✔ Among the findings, GI bleeding poses the most immediate threat.

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Answer 7

Correct Answers:

Weight gain of 2 pounds (0.91 kg) in one day

Rationale :

🟡 SIADH causes water retention, leading to rapid weight gain without edema.

🟡 It results in dilutional hyponatremia, which can cause neurological symptoms.

🟡 Monitoring weight is key to detecting fluid overload early.

🟡 A 2-lb increase in 24 hours is significant and supports SIADH diagnosis.

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Answer 8

Correct Answers:

Continue to monitor the drainage system

Rationale :

🔵 Water-seal fluctuation (tidaling) is normal, indicating patent tubing and proper lung re-expansion.

🔵 The rising and falling with inspiration and expiration confirms the system is functioning correctly.

🔵 No signs of air leak or system failure are observed, so no intervention is needed.

🔵 The nurse should document and continue observing.

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Answer 9

Correct Answers:

High-pitched sound heard upon inspiration.

Rationale :

🔴 A high-pitched inspiratory sound (stridor) suggests airway narrowing or obstruction.

🔴 This is an emergency and could indicate laryngeal edema or respiratory distress.

🔴 Airway assessment and protection take priority over pain or wound issues.

🔴 Immediate evaluation and possible intubation may be necessary

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Answer 10

Correct Answers:

Calcium 6.5 mg/dL (1.63 mmol/L).

Rationale :

🟣 A calcium level of 6.5 is severely low and can cause neuromuscular symptoms, including cramping and stridor.

🟣 Hypocalcemia can lead to tetany, seizures, or cardiac abnormalities.

🟣 Blood transfusions can cause citrate toxicity, leading to calcium binding and depletion.

🟣 This lab value correlates with the client's presenting symptoms and requires urgent correction.

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RN-Hesi Medical Surgical Exam V

No.

1 :
A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?
Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

3 :
A client with type 1 diabetes mellitus, hypertension, and chronic kidney disease is to begin hemodialysis treatment. Which statement should the nurse include in client education?

4 :
A patient is admitted to the hospital with symptoms consistent with a right hemisphere stroke. Which neurovascular assessment requires immediate intervention by the nurse?

6 :
A client who had a biliopancreatic diversion procedure (BPD) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

7 :
A client with a closed head injury demonstrates signs of syndrome of inappropriate antidiuretic hormone (SIADH). Which additional finding should the nurse expect to obtain?

9 :
The nurse is caring for a client who had an appendectomy 4 hours ago. Which finding requires immediate action by the nurse?

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RN-Hesi Medical Surgical Exam V

No.

1 : A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

3 : A client with type 1 diabetes mellitus, hypertension, and chronic kidney disease is to begin hemodialysis treatment. Which statement should the nurse include in client education?

4 : A patient is admitted to the hospital with symptoms consistent with a right hemisphere stroke. Which neurovascular assessment requires immediate intervention by the nurse?

6 : A client who had a biliopancreatic diversion procedure (BPD) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

7 : A client with a closed head injury demonstrates signs of syndrome of inappropriate antidiuretic hormone (SIADH). Which additional finding should the nurse expect to obtain?

9 : The nurse is caring for a client who had an appendectomy 4 hours ago. Which finding requires immediate action by the nurse?

1 :
A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?
Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

3 :
A client with type 1 diabetes mellitus, hypertension, and chronic kidney disease is to begin hemodialysis treatment. Which statement should the nurse include in client education?

4 :
A patient is admitted to the hospital with symptoms consistent with a right hemisphere stroke. Which neurovascular assessment requires immediate intervention by the nurse?

6 :
A client who had a biliopancreatic diversion procedure (BPD) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

7 :
A client with a closed head injury demonstrates signs of syndrome of inappropriate antidiuretic hormone (SIADH). Which additional finding should the nurse expect to obtain?

9 :
The nurse is caring for a client who had an appendectomy 4 hours ago. Which finding requires immediate action by the nurse?