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A nurse is administering furosemide 80 mg PO twice daily to a client who has pulmonary edema. Which of the following assessment findings indicates to the nurse that the medication is effective?
- A. Adventitious breath sounds
- B. Respiratory rate of 24/min
- C. Weight loss of 1.8 kg (4 lb) in the past 24 hr
- D. Elevation in blood pressure
Correct Answer: C
Rationale: The correct answer is C: Weight loss of 1.8 kg (4 lb) in the past 24 hr. Furosemide is a diuretic that helps to reduce fluid retention, so weight loss indicates the medication is effectively reducing pulmonary edema. Adventitious breath sounds indicate respiratory issues, not medication effectiveness. A respiratory rate of 24/min could be within normal range and not necessarily indicative of medication effectiveness. Elevation in blood pressure could indicate a potential adverse effect of furosemide, not effectiveness. Weight loss is the most direct indicator of reduced fluid volume due to diuresis.
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A nurse is providing teaching to a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will take this medication with food to help with absorption.
- B. If my heart starts racing
- C. my provider might need to adjust my dosage.
- D. I should stop taking this medication once my symptoms improve.
- E. I will take this medication at night before bed.
Correct Answer: B
Rationale: Correct Answer: B - If my heart starts racing
Rationale: This statement indicates an understanding of a potential side effect of levothyroxine, which is palpitations or rapid heart rate. It shows that the client is aware of the importance of monitoring for adverse reactions and seeking medical attention if necessary. This is crucial as it can indicate overmedication, which can be harmful.
Incorrect Choices:
A: Taking levothyroxine with food can interfere with its absorption, reducing its effectiveness.
C: Adjusting the dosage is the healthcare provider's responsibility based on lab results, not the client's decision.
D: Stopping the medication abruptly can lead to a worsening of hypothyroidism symptoms.
E: Taking levothyroxine at night can interfere with sleep patterns and absorption.
A nurse is preparing to administer daily medications to a client who is undergoing a procedure at 1000 that requires IV contrast dye. Which of the following routine medications to give at 0800 should the nurse withhold?
- A. Fluticasone
- B. Metoprolol
- C. Metformin
- D. Valproic acid
Correct Answer: C
Rationale: The correct answer is C: Metformin. The nurse should withhold metformin before the procedure with IV contrast dye due to the risk of lactic acidosis. IV contrast dye can affect kidney function, leading to an increased risk of lactic acidosis when combined with metformin. Fluticasone (A), metoprolol (B), and valproic acid (D) are not contraindicated before the procedure with IV contrast dye. Fluticasone is an inhaled corticosteroid, metoprolol is a beta-blocker, and valproic acid is an anticonvulsant. These medications are not typically affected by IV contrast dye and can be safely administered.
A nurse is preparing to administer propranolol to several clients. For which of the following clients should the nurse clarify the prescription with the provider before administration?
- A. A client who has a history of asthma
- B. A client who has hypertension
- C. A client who has a history of migraines
- D. A client who has stable angina
Correct Answer: A
Rationale: The correct answer is A. Propranolol is a non-selective beta-blocker that can potentially worsen asthma symptoms by causing bronchoconstriction. Therefore, for a client with a history of asthma, the nurse should clarify the prescription with the provider to avoid exacerbating respiratory issues. The other choices (B, C, D) do not typically contraindicate propranolol administration, as it is commonly used to manage hypertension, migraines, and stable angina. It is important to consider individual client factors when administering medications to ensure safety and effectiveness.
A nurse is preparing to administer potassium chloride 10 mEq IV over 1 hr to a client. Available is potassium chloride 10 mEq in 100 mL of 0.9% sodium chloride. The nurse should set the infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)
- A. 50 mL/hr
- B. 75 mL/hr
- C. 100 mL/hr
- D. 125 mL/hr
Correct Answer: C
Rationale: To determine the infusion rate, we first calculate the total volume of the solution to be infused (100 mL) over the total time (1 hr). Therefore, the infusion pump should be set to deliver 100 mL/hr (Choice C). This ensures the correct administration of potassium chloride 10 mEq IV over 1 hr. Choices A, B, and D are incorrect because they do not accurately reflect the infusion rate required for the specified dose and time frame.
A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following should the nurse identify as a contributing factor to the client's manifestations?
- A. Suppressed bronchiolar inflammatory response
- B. Decreased responsiveness of airways to allergens
- C. Acute loss of alveolar elasticity
- D. Inability to exhale retained carbon dioxide
Correct Answer: D
Rationale: The correct answer is D: Inability to exhale retained carbon dioxide. During an acute asthma attack, there is airway obstruction, leading to air trapping and difficulty exhaling. This causes retention of carbon dioxide, leading to respiratory acidosis. This acidosis can further worsen the bronchoconstriction and airway inflammation in asthma. Choices A, B, and C do not directly contribute to the manifestations of an acute asthma attack. Suppressed bronchiolar inflammatory response (A) and decreased responsiveness of airways to allergens (B) would not cause the acute symptoms seen in an asthma attack. Acute loss of alveolar elasticity (C) is not a primary contributing factor to the acute manifestations of asthma.