Nursing Elites

1. The nurse is assessing a client with chronic heart failure who is receiving furosemide (Lasix). Which assessment finding is most concerning?

• A. Heart rate of 60 beats per minute
• B. Blood pressure of 110/70 mmHg
• C. Elevated liver enzymes
• D. Elevated blood glucose level

Correct answer: C

Rationale: Elevated liver enzymes are most concerning in a client with chronic heart failure as they may indicate liver congestion or worsening heart failure, requiring immediate intervention. Elevated liver enzymes can be a sign of hepatotoxicity or liver damage, which could be a result of furosemide (Lasix) use. Monitoring liver function is crucial in patients taking furosemide due to the risk of hepatotoxicity. A heart rate of 60 beats per minute and a blood pressure of 110/70 mmHg are within normal ranges for a client with chronic heart failure. An elevated blood glucose level may be expected due to the effects of furosemide but is not as immediately concerning as elevated liver enzymes.

2. In a client with heart failure receiving digoxin (Lanoxin) and furosemide (Lasix), which laboratory value requires immediate intervention?

• A. Serum potassium of 4.0 mEq/L
• B. Blood glucose of 200 mg/dl
• C. Serum creatinine of 1.5 mg/dl
• D. Serum potassium of 3.2 mEq/L

Correct answer: D

Rationale: A serum potassium level of 3.2 mEq/L is low and concerning in a client receiving digoxin and furosemide. Hypokalemia increases the risk of digoxin toxicity, leading to life-threatening arrhythmias. Therefore, immediate intervention is necessary to prevent complications. The other options, serum potassium of 4.0 mEq/L, blood glucose of 200 mg/dl, and serum creatinine of 1.5 mg/dl, are within normal limits and do not pose immediate risks to the client in this scenario.

3. The healthcare provider is assessing a client with chronic kidney disease (CKD) who is receiving erythropoietin therapy. Which clinical finding is most concerning?

• A. Increased fatigue
• B. Elevated blood pressure
• C. Elevated hemoglobin
• D. Low urine output

Correct answer: B

Rationale: In a client with chronic kidney disease (CKD) receiving erythropoietin therapy, elevated blood pressure is the most concerning finding. Elevated blood pressure can indicate worsening hypertension, which requires immediate intervention to prevent further damage to the kidneys and other organs. Increased fatigue (choice A) is a common symptom in CKD but may not be as acutely concerning as elevated blood pressure. Elevated hemoglobin (choice C) can be an expected outcome of erythropoietin therapy and is not necessarily concerning. Low urine output (choice D) is important to monitor in CKD but may not be as immediately concerning as elevated blood pressure in this context.

4. A client with a history of chronic kidney disease (CKD) is scheduled for a CT scan with contrast. Which laboratory value should the nurse review before the procedure?

• A. Serum creatinine
• B. Blood urea nitrogen (BUN)
• C. Serum potassium
• D. Serum glucose

Correct answer: A

Rationale: The correct answer is A: Serum creatinine. Before a CT scan with contrast, the nurse should review the serum creatinine level. This is crucial in patients with CKD because contrast agents can potentially worsen kidney function and lead to contrast-induced nephropathy. Monitoring serum creatinine helps assess kidney function and determine the risk of complications. Choices B, C, and D are less relevant in this scenario. Blood urea nitrogen (BUN) is another marker of kidney function, but serum creatinine is a more specific indicator. Serum potassium levels are important in assessing electrolyte balance but are not directly related to the risk of contrast-induced nephropathy. Serum glucose levels are not typically a primary concern before a CT scan with contrast in a patient with CKD.

5. A nurse is preparing to insert a nasogastric tube (NGT) in a client. Which action should the nurse take first?

• A. Assess the client's history for nasal trauma or surgery
• B. Ask the client to cough and deep breathe.
• C. Measure the length of the tube to be inserted.
• D. Explain the procedure to the client and obtain consent.

Correct answer: D

Rationale: The correct first action for the nurse to take when preparing to insert a nasogastric tube (NGT) in a client is to explain the procedure to the client and obtain consent. It is crucial to ensure that the client is informed about the procedure, understands it, and consents to it before proceeding. Assessing the client's history for nasal trauma or surgery (Choice A) is important but can be done after obtaining consent. Asking the client to cough and deep breathe (Choice B) is not directly related to the initial step of preparing for NGT insertion. Measuring the length of the tube to be inserted (Choice C) is a necessary step but should come after explaining the procedure and obtaining consent.

Similar Questions