Nokea
A client is scheduled for a multiple gated acquisition (MUGA) scan the following day. What medication is contraindicated for the nurse to administer the morning of the procedure?
- A. Furosemide
- B. Acetaminophen
- C. Morphine sulfate
- D. Guaifenesin
Correct Answer: A
Rationale: Diuretics are contraindicated the morning of a test to avoid any interruptions for urination. Clients are also medicated to relieve a cough that may cause movement during the test so administration of guaifenesin is not contraindicated. Acetaminophen and morphine sulfate are not contraindicated the morning of the test.
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A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion?
- A. Assess for reduced urine output.
- B. Assess for reduced blood sodium levels.
- C. Assess for elevated blood potassium levels.
- D. Assess for elevated blood urea nitrogen levels.
Correct Answer: D
Rationale: Elevated blood urea nitrogen indicates impaired renal perfusion in a client with left-sided heart failure. Serum sodium levels may be elevated. Reduced urine output or elevated blood potassium levels do not indicate impaired renal perfusion in a client with left-sided heart failure.
A client with severe mitral valve insufficiency has been admitted to the unit. The client has heart failure and has developed pulmonary edema. What would be the best course of treatment for this client?
- A. Cardiac glycosides
- B. Beta-blockers
- C. Surgery
- D. Palliative care
Correct Answer: C
Rationale: If the cause of heart failure and pulmonary edema can be corrected surgically (e.g., a mitral valve disorder), the client is supported medically while being prepared for surgery. The other options do not have the potential to reverse or stabilize this client's disease process, so they would not be the best treatment option.
The nurse is administering captopril to a client with a diagnosis of heart failure. What type of medication does the nurse infer the client is taking?
- A. An angiotensin converting enzyme inhibitor (ACE) inhibitor
- B. A thiazide diuretic
- C. An angiotensin receptor blocker (ARB)
- D. A calcium channel blocker
Correct Answer: A
Rationale: Captopril is an ACE inhibitor. Although the other medications may be used alone or in conjunction with other medications, the ACE inhibitor is a standard medication used in heart failure unless not tolerated by the client.
The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse?
- A. Administer the medication and inform the charge nurse about the rate.
- B. Withhold the medication and notify the health care provider of the heart rate.
- C. Administer atropine to speed the heart rate and then administer the digoxin.
- D. Administer the medications and then notify the health care provider.
Correct Answer: B
Rationale: Digitalis drugs are withheld if the heart rate is less than 60 or more than 120 beats/minute until a health care provider is consulted. The other choices would have the nurse administer the drug, which would not be the standard of practice.
The nurse documents pitting edema in the bilateral lower extremities of the client. What does this documentation mean?
- A. There is excess fluid volume in the interstitial space in areas affected by gravity.
- B. There is excess fluid volume in the venous system of the lower extremities.
- C. There is excess fluid volume in the arterial system of the lower extremities.
- D. There is excess fluid volume in the hepatic system.
Correct Answer: A
Rationale: Dependent pitting edema (excess fluid volume in the interstitial space in body areas affected by gravity) in the feet and ankles can be observed. This type of edema may seem to disappear overnight but really is temporarily redistributed by gravity to other tissues, such as the sacral area. The other options are not descriptive of pitting edema.