PSA PSA Fluid and Electrolyte Prescribing 2

Question 1

A patient has a serum potassium of 2.8 mEq/L with ECG changes showing U waves. What is the most appropriate management?

Accepted Answer

IV potassium replacement with cardiac monitoring

Answer

Symptomatic hypokalemia with ECG changes requires IV potassium replacement with continuous cardiac monitoring due to arrhythmia risk.

Question 2

What is the maximum recommended rate of IV potassium infusion via a peripheral line to minimize risk of phlebitis and cardiac toxicity?

Accepted Answer

10 mEq/hour

Answer

Peripheral IV potassium should not exceed 10 mEq/hour to minimize the risk of vein irritation and potentially fatal cardiac arrhythmias.

Question 3

A patient with severe hyperkalemia (K+ 6.8 mEq/L) shows peaked T waves on ECG. What is the most immediate priority?

Accepted Answer

Give IV calcium gluconate to stabilize the cardiac membrane

Answer

IV calcium gluconate is given first in severe hyperkalemia with ECG changes because it immediately stabilizes the cardiac membrane to prevent arrhythmias.

Question 4

A patient on loop diuretics presents with muscle cramps and a serum magnesium of 1.0 mg/dL (normal 1.7–2.2 mg/dL). Their hypokalemia is refractory to potassium replacement. What should be corrected first?

Accepted Answer

Correct hypomagnesemia before further potassium replacement

Answer

Hypomagnesemia causes renal potassium wasting; correcting magnesium deficiency is necessary for potassium replacement to be effective.

Question 5

Which of the following is the correct treatment for severe symptomatic hyponatremia (Na+ 115 mEq/L with seizures)?

Accepted Answer

Hypertonic saline (3% NaCl) infusion

Answer

Severe symptomatic hyponatremia with seizures requires hypertonic saline infusion to rapidly raise sodium and reduce cerebral edema.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA PSA Fluid and Electrolyte Prescribing 2