NCLEX Practice Exam/Test - Level of Cognitive Ability (Analysis 1-5)

1. A nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:

a) has renal failure
b) requires nasogastric suction
c) has a history of Addison's disease
d) is taking a potassium-sparing diuretic


2. A nurse reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the nurse note on the electrocardiogram as a result of the laboratory value?

a) U waves
b) absent P waves
c) elevated T waves
d) elevated ST segment

3. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?

a) the client with colitis
b) the client with Cushing's syndrome
c) the client who has been overusing laxatives
d) the client who has sustained a traumatic burn

4. A nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.4 mEq/L. Which of the following would the nurse expect to note on the electrocardiogram as a result of the laboratory value?

a) ST depression
b) inverted T wave
c) prominent U wave
d) tall peaked T waves

5. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of sodium value at this level?

a) the client with renal failure
b) the client who is taking diuretics
c) the client with hyperaldosteronism
d) the client who is taking corticosteroids



ANSWERS AND RATIONALE

1) B

 - potassium-rich gastrointestinal fluids are lost through gastrointestinal suction, placing the client at risk for hypokalemia. The client with renal failure or Addison's disease and the client taking a potassium-sparing diuretic are at risk for hyperkalemia.

2) A

- a serum potassium level lower than 3.5 mEq/L indicates hypokalemia. Potassium deficit is a common electrolyte imbalance and is potentially life threatening. Electrocardiographic changes include inverted T waves, ST segment depression, and prominent U waves. Absent P waves are not a characteristic of hypokalemia.

3) D

- a serum potassium level higher that 5.1 mEq/L indicates hyperkalemia. Clients who experience cellular shifting of potassium in the early stage of massive cell destruction such as trauma, burns, sepsis, or metabolic or respiratory acidosis, are at risk for hyperkalemia. The client with Cushing's syndrome or colitis and the client who has been overusing laxatives are at risk for hypokalemia.

4) D

- a serum potassium level higher that 5.1 mEq/L indicates hyperkalemia. Electrocardiogram changes include flat P waves, prolonged PR intervals, widened QRS complexes, and tall peaked T waves.

5) B

- hyponatremia is evidenced by a serum sodium level lower than 135 mEq/L. Hyponatremia can occur in the client taking diuretics. The client taking corticosteroids and the client with renal failure or hypoaldosteronism are at risk for hypernatremia.


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