Correct Answer:

b) initiate iv potassium replacement

Rationale:

Rationale:Severe hypokalemia (<3.0 mEq/L) can lead to cardiac arrhythmias and muscle weakness. IV potassium is required for rapid correction. Sodium restriction and antihypertensive adjustments are important but secondary to addressing the immediate hypokalemia.

-A: Oral replacement is too slow for severe hypokalemia (K+ 2.8) with symptoms (muscle weakness), which can progress to cardiac arrhythmias.

-C: Sodium restriction helps long-term management of hypertension in aldosteronism, but it does not correct the immediate life-threatening low potassium

-D: While BP control is important, the **priority** is correcting hypokalemia since it poses the most urgent risk to the patient’s safety.

Correct Answer:

c) gastrointestinal bleeding

Rationale:

Rationale: Black, tarry stools (melena) often indicate bleeding in the upper gastrointestinal tract. While iron supplements can darken stool, it typically does not have the tarry consistency associated with melena.

-A: Hemorrhoids usually cause bright red blood (hematochezia) on the stool or toilet paper, not black/tarry stool.

-B: Iron supplements can darken stool, but the stool typically appears dark green or blackish-brown, not tarry and sticky like melena.

-D: Viral gastroenteritis usually causes watery diarrhea, nausea, and cramping, not melena.

Correct Answer:

d) start 0.9% normal saline infusion.

Rationale:

Rationale: The priority intervention for a patient with DKA is restoring fluid volume with 0.9% normal saline. DKA causes osmotic diuresis, leading to severe dehydration. Insulin administration comes after fluid resuscitation to prevent rapid shifts in potassium, which could lead to life-threatening arrhythmias. Sodium bicarbonate is not routinely given unless pH <7.0.

-A: The patient already has **hyperkalemia (K+ 5.8)** due to acidosis and insulin deficiency. Giving more potassium could cause life-threatening arrhythmias.

*-* B: Insulin is necessary to correct hyperglycemia and shift potassium back into the cells, but it is **not the first priority**—fluids must be started before insulin to prevent vascular collapse.

-C: Bicarbonate is rarely indicated in DKA except for extreme acidosis (pH < 6.9). Routine use can cause rebound alkalosis and worsen hypokalemia once insulin is given.

Correct Answer:

c) deficient fluid volume

Rationale:

Rationale: Diarrhea can lead to dehydration and electrolyte imbalances, making Deficient Fluid Volume a priority diagnosis. Monitoring hydration and addressing fluid loss are essential in managing this condition.

- A: Diarrhea doesn’t directly limit a patient’s ability to move, so this is not the priority concern.
- B: Diarrhea affects the gastrointestinal system, not the respiratory system.
- D: While frequent stools can irritate the skin, preventing fluid loss is more urgent.

Correct Answer:

a) aluminum hydroxide

Rationale:

Rationale Aluminum-containing antacids are commonly associated with constipation.

- B:Magnesium hydroxide causes diarrhea, not constipation.
- C:Calcium carbonate can cause constipation but is less likely than aluminum hydroxide.
- D Sodium bicarbonate is not typically associated with constipation.