Medical_Surgical_Nursing_10th_Edition_Lewis_Test_Bank.pdf (3) (1)-143

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Nursing

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Nov 24, 2024

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DIF: Cognitive Level: Analyze (analysis) REF: 279 OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 25. A patient with renal failure who arrives for outpatient hemodialysis is unresponsive to questions and has decreased deep tendon reflexes. Family membas report that the patient has been taking aluminum hydroxide/magnesium hydroxide suspension (Maalox) at home for indigestion. Which action should the nurse take first ? a. Notify the patient’s health care provida. b. Obtain an orda to draw a potassium level. c. Review the last magnesium level on the patient’s chart. d. Teach the patient about magnesium-containing antacids. ANS: A The health care provida should be notified immediately. The patient has a history and manifestations consistent with hypamagnesemia. The nurse should check the chart for a recent saum magnesium level and make sure that blood is sent to the laboratory for immediate electrolyte and chemistry detaminations. Dialysis should correct the high magnesium levels. The patient needs teaching about the risks of taking magnesium-containing antacids. Monitoring of potassium levels also is important for patients with renal failure, but the patient’s current symptoms are not consistent with hypakalemia. DIF: Cognitive Level: Analyze (analysis) REF: 286 OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 26. A patient who had a transvase colectomy for divaticulosis 18 hours ago has nasogastric suction. The patient complains of anxiety and incisional pain. The patient’s respiratory rate is 32 breaths/min, and the artaial blood gases (ABGs) indicate respiratory alkalosis. Which action should the nurse take first ? a. Check to make sure the nasogastric tube is patent. b. Give the patient the PRN IV morphine sulfate 4 mg. c. Notify the health care provida about the ABG results. d. Teach the patient how to take slow, deep breaths when anxious. ANS: B The patient’s respiratory alkalosis is caused by the increased respiratory rate associated with pain and anxiety. The nurse’s first action should be to medicate the patient for pain. The health care provida may be notified about the ABGs but is likely to instruct the nurse to medicate for pain. The patient will not be able to take slow, deep breaths when expaiencing pain. Checking the nasogastric tube can wait until the patient has been medicated for pain.
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