Introduction
Scenario setup A client on hemodialysis complains of numbness and weakness. SpO₂ 96%, HR 52 then pauses on monitor, BP 162/88. The telemetry shows peaked T waves and widening QRS. Potassium reported as 6.9 mEq/L (if shown). This is life-threatening hyperkalemia until treated. PN priorities: continuous monitoring, notify RN/provider immediately, prepare calcium therapy, insulin/dextrose, albuterol, kayexalate—only per orders—and avoid independent dosing. PN traps: routine vitals q4h when ECG is worsening, walking the client, or delaying notification. This case-study format is intentional: boards reward trajectory thinking—what changed, what is unstable, and what you do next for the role named in the stem. For NCLEX-PN (United States), read the assignment line before you eliminate answers. Slow read: re-scan the stem for vitals trends, oxygen settings, allergies, and time since onset—case items often hide the decisive clue in a single line. On the exam, writers often pair with —notice the mismatch before you commit. If the stem names a , reread that line; are classic trap answers even when the clinical topic is familiar. Run a...