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 of 6.7 mEq/L indicates severe hyperkalemia, which poses a life-threatening risk of cardiac arrhythmias.

🔴 Sodium polystyrene sulfonate works by binding potassium in the intestine, promoting its excretion via feces.

🔴 It provides a non-invasive and immediate intervention to lower serum potassium.

🔴 This treatment should be administered prior to other maintenance therapies for chronic renal failure.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

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

Rationale :

🟡 Elevated creatinine signals renal impairment, increasing the risk of nephrotoxicity from contrast dye used in MRI.

🟡 The provider must assess renal function status before proceeding to avoid contrast-induced nephropathy.

🟡 Creatinine is a direct indicator of glomerular filtration efficiency, unlike glucose or A1C.

🟡 Reporting this value can prevent irreversible kidney damage post-contrast administration.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

Expect the insulin dosage to be reduced.

Rationale :

🟢 Clients on hemodialysis experience decreased insulin requirements due to impaired renal clearance.

🟢 Hemodialysis also affects glucose metabolism, increasing risk for hypoglycemia if insulin doses are unchanged.

🟢 Patient education should emphasize adjustments to diabetes management post-dialysis initiation.

🟢 Routine insulin regimens must be reevaluated in clients with chronic kidney disease.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

Pupillary changes to ipsilateral dilation.

Rationale :

🔵 A unilateral dilated pupil indicates increased intracranial pressure and potential brain herniation, requiring emergency intervention.

🔵 This is a neurological emergency and is more urgent than weakness or grip strength changes.

🔵 Stroke symptoms affecting pupils suggest worsening cerebral edema or brainstem compression.

🔵 Immediate reporting and intervention are essential to prevent further neurologic deterioration.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

Begin preparing the client for discharge home.

Rationale :

🟣 The client exhibits stable vital signs, intact cognition, and adherence understanding of Addison’s disease management.

🟣 The presence of moist mucous membranes and normal BP indicates effective treatment and fluid balance.

🟣 Verbalizing medication compliance shows readiness for self-management at home.

🟣 No abnormal findings necessitate prolonged hospitalization.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

Complaint of poor night vision.

Rationale :

🟤 Night blindness is an early sign of vitamin A deficiency, a common complication after biliopancreatic diversion (BPD).

🟤 BPD patients often experience malabsorption of fat-soluble vitamins (A, D, E, K).

🟤 This symptom needs prompt supplementation to prevent permanent vision impairment.

🟤 Unlike diarrhea or flatus, this indicates a serious nutrient deficiency post-surgery.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

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

Rationale :

⚪ SIADH leads to fluid retention, causing rapid weight gain without edema due to water, not sodium, accumulation.

⚪ A gain of 2 lbs in 24 hours is clinically significant and indicates fluid overload.

⚪ It reflects a dilutional hyponatremia pattern, common in SIADH.

⚪ This is consistent with ADH overproduction, a concern in head injury clients.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

Continue to monitor the drainage system.

Rationale :

🔶 The rise and fall of water in the seal chamber with breathing is a normal finding, indicating patent chest tube and proper negative pressure.

🔶 No evidence of air leaks or malfunction is noted.

🔶 Monitoring without unnecessary interference ensures chest tube effectiveness.

🔶 Immediate interventions are not needed unless abnormal findings emerge.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

High-pitched sound heard upon inspiration.

Rationale :

🟥 Stridor is a high-pitched inspiratory sound indicating upper airway obstruction, which is life-threatening.

🟥 This finding may reflect laryngeal edema or aspiration, requiring emergency airway support.

🟥 It supersedes pain or local incision changes in urgency.

🟥 The nurse must notify the provider and prepare for airway management.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

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

Rationale :

🟡 A calcium level of 6.5 mg/dL indicates severe hypocalcemia, which causes muscle cramps, tetany, and stridor.

🟡 This is often seen after multiple blood transfusions due to citrate binding to calcium.

🟡 Neuromuscular excitability and respiratory symptoms demand immediate treatment.

🟡 Untreated hypocalcemia can lead to laryngeal spasm and cardiac arrhythmias.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

RN-Hesi Medical Surgical Exam VI

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?

Connect With Us

RN-Hesi Medical Surgical Exam VI

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?