# A client with kidney failure has serum potassium 6.7 mEq/L and peaked T waves on the ECG. Which prescription should the nurse anticipate as the immediate priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397257&lang=en  
> language: en  
> subject: Illness Management  
> category: PA

## Question

A client with kidney failure has serum potassium 6.7 mEq/L and peaked T waves on the ECG. Which prescription should the nurse anticipate as the immediate priority?

## Option

1. Administer oral potassium supplements.
2. Encourage foods high in potassium.
3. Administer IV calcium gluconate as prescribed. **✔ Correct answer**
4. Hold all fluids for the next 24 hours.

**Correct answer: 3**

## Explanation

Severe hyperkalemia with ECG changes threatens cardiac conduction. IV calcium gluconate is used to stabilize the myocardium while other therapies shift or remove potassium. Potassium supplements or high-potassium foods would worsen the problem.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Hyperkalemia with ECG changes.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Hyperkalemia with ECG changes, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Hyperkalemia** — An elevated serum potassium level that can cause dangerous dysrhythmias.
- **Peaked T Wave** — An ECG change associated with elevated potassium.
- **Calcium Gluconate** — A medication used to stabilize cardiac membranes during severe hyperkalemia.

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