Nursing Elites

1. A client with heart failure is receiving intravenous furosemide (Lasix). Which assessment finding indicates that the medication is having the desired effect?

• A. Decreased peripheral edema.
• B. Elevated blood pressure.
• C. Increased heart rate.
• D. Decreased urine output.

Correct answer: A

Rationale: The correct answer is A: 'Decreased peripheral edema.' In a client with heart failure receiving furosemide, decreased peripheral edema indicates that the medication is effectively reducing fluid overload. Furosemide is a diuretic that helps the body eliminate excess fluid and salt through increased urine output, leading to a reduction in peripheral edema, which is a common symptom of heart failure. Monitoring and recognizing this improvement in edema are crucial in managing heart failure effectively.

2. A client with chronic kidney disease is prescribed a low-protein diet. Which laboratory result should the nurse monitor to evaluate the effectiveness of the diet?

• A. Blood urea nitrogen (BUN)
• B. Serum potassium
• C. Serum calcium
• D. Creatinine clearance

Correct answer: A

Rationale: Blood urea nitrogen (BUN) levels should be monitored to assess the effectiveness of a low-protein diet in clients with chronic kidney disease. BUN levels reflect the breakdown of protein in the body, and a low-protein diet aims to reduce BUN levels to lessen the workload on the kidneys. Therefore, monitoring BUN levels is crucial in managing kidney function and evaluating the impact of dietary modifications. Serum potassium, serum calcium, and creatinine clearance are important parameters to monitor in clients with chronic kidney disease, but they are not specifically indicative of the effectiveness of a low-protein diet. Serum potassium levels are crucial in assessing electrolyte balance, serum calcium levels are important for bone health and nerve function, and creatinine clearance reflects kidney function overall, not just the impact of a low-protein diet.

3. A 50-year-old man presents with severe epigastric pain radiating to his back, nausea, and vomiting. He has a history of heavy alcohol use. Laboratory tests reveal elevated serum amylase and lipase. What is the most likely diagnosis?

• A. Acute cholecystitis
• B. Peptic ulcer disease
• C. Acute pancreatitis
• D. Gastroesophageal reflux disease

Correct answer: C

Rationale: The patient's history of heavy alcohol use, severe epigastric pain radiating to the back, nausea, vomiting, and elevated serum amylase and lipase levels are classic signs of acute pancreatitis. Alcohol consumption is a common predisposing factor for pancreatitis, leading to inflammation of the pancreas. The clinical presentation, along with the laboratory findings, strongly support the diagnosis of acute pancreatitis in this patient.

4. The client has a nasogastric (NG) tube and is receiving enteral feedings. What intervention should the nurse implement to prevent complications associated with the NG tube?

• A. Flush the NG tube with water before and after feedings.
• B. Check gastric residual volume every 6 hours.
• C. Keep the head of the bed elevated at 30 degrees.
• D. Replace the NG tube every 24 hours.

Correct answer: C

Rationale: Keeping the head of the bed elevated at 30 degrees is crucial in preventing aspiration, a common complication associated with nasogastric (NG) tubes and enteral feedings. This position helps reduce the risk of reflux and aspiration of gastric contents into the lungs, promoting client safety and preventing respiratory complications. Flushing the NG tube with water before and after feedings (Choice A) is not the primary intervention to prevent complications. Checking gastric residual volume every 6 hours (Choice B) is important but not directly related to preventing complications associated with the NG tube. Replacing the NG tube every 24 hours (Choice D) is not a standard practice and is not necessary to prevent complications if the tube is functioning properly.

5. A client with left-sided heart failure is experiencing dyspnea and orthopnea. Which position should the nurse place the client in to relieve these symptoms?

• A. High Fowler's position.
• B. Supine position.
• C. Trendelenburg position.
• D. Sims' position.

Correct answer: A

Rationale: Placing the client in High Fowler's position is beneficial for individuals with left-sided heart failure experiencing dyspnea and orthopnea. This position helps to reduce venous return, decrease preload, and enhance respiratory function, thereby relieving the symptoms mentioned. Choice B, the supine position, is not recommended as it may exacerbate dyspnea and orthopnea by increasing preload. Choice C, the Trendelenburg position, is incorrect as it involves the feet being positioned higher than the head, which is not suitable for heart failure patients. Choice D, the Sims' position, is a lateral position used for rectal examination and is not indicated for relieving dyspnea and orthopnea in heart failure.

Similar Questions