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The healthcare professional is assisting in the care of a client diagnosed with heart failure. The client is receiving furosemide (Lasix). Which laboratory value should the healthcare professional monitor most closely?
- A. Serum calcium
- B. Serum potassium
- C. Serum sodium
- D. Serum glucose
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can lead to significant potassium loss, making it crucial to monitor the client's serum potassium levels. Hypokalemia (low potassium levels) can result from furosemide use, potentially leading to adverse effects such as cardiac dysrhythmias. Therefore, close monitoring of serum potassium levels is essential to prevent complications in clients receiving furosemide. Monitoring serum calcium, sodium, or glucose levels is not the priority when administering furosemide.
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A CNM:
- A. may treat only women.
- B. has prescriptive authority in all 50 states.
- C. may administer only drugs used during labor and delivery.
- D. may practice only in birthing centers and home birth settings.
Correct Answer: B
Rationale: The correct answer is B because CNMs have prescriptive authority in all 50 states. Choice A is incorrect as they can treat partners for STDs. Choice C is wrong since their authority isn’t limited to labor drugs. Choice D is inaccurate as they practice in various settings.
A client with a history of angina pectoris reports chest pain while ambulating in the corridor. What should the nurse do first?
- A. Check the client's vital signs.
- B. Assist the client to sit or lie down.
- C. Administer sublingual nitroglycerin.
- D. Apply nasal oxygen at a rate of 2 L/min.
Correct Answer: B
Rationale: When a client with a history of angina pectoris experiences chest pain while ambulating, the priority action for the nurse is to assist the client to sit or lie down. This helps reduce the demand on the heart by decreasing physical exertion. Checking vital signs, administering medication, or applying oxygen can follow once the client is in a more comfortable position. Checking vital signs (Choice A) may be important but addressing the immediate discomfort by positioning the client comfortably takes precedence. Administering sublingual nitroglycerin (Choice C) is appropriate but should come after ensuring the client's comfort. Applying nasal oxygen (Choice D) can be beneficial, but it should not be the first action; assisting the client to sit or lie down is the initial priority.
Drugs that should be avoided in transgender men receiving testosterone therapy include:
- A. Estrogen
- B. Alpha blockers
- C. Beta blockers
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because estrogen counteracts testosterone's masculinizing effects in transgender men, conflicting with therapy aims, so it's avoided. Choice B is incorrect as alpha blockers don't interfere with testosterone goals. Choice C is wrong because beta blockers are unrelated to therapy effects. Choice D is incorrect since only estrogen applies.
The client with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance is the nurse most likely to monitor for?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hyponatremia
Correct Answer: C
Rationale: The correct answer is C: Hypokalemia. Furosemide, a loop diuretic, commonly causes potassium loss, leading to hypokalemia. The nurse should closely monitor for decreased potassium levels in a client receiving furosemide to prevent complications such as cardiac arrhythmias or muscle weakness. Hyperkalemia (Choice A) is not typically associated with furosemide use. Hypernatremia (Choice B) refers to high sodium levels and is not the primary concern with furosemide. Hyponatremia (Choice D) is low sodium levels, which can occur but is less common than hypokalemia in clients taking furosemide.
A client with a history of angina pectoris reports chest pain after climbing stairs. What should be the nurse's first action?
- A. Administer oxygen.
- B. Administer nitroglycerin.
- C. Sit the client down and rest.
- D. Check the client's blood pressure.
Correct Answer: C
Rationale: The correct action for a client experiencing anginal pain, like chest pain after climbing stairs, is to sit the client down and have them rest. Resting reduces myocardial oxygen demand, which can help relieve anginal pain. Administering oxygen or nitroglycerin may be appropriate interventions after the client has been seated and rested. Checking the client's blood pressure is important but not the immediate priority when a client is experiencing anginal pain. Therefore, the first action should be to sit the client down and allow them to rest.