Nursing Elites

1. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

2. A healthcare professional is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the healthcare professional prepare to transfuse?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the correct choice for a client with an elevated aPTT because it contains essential coagulation factors that can help correct coagulopathy and prevent bleeding. It is rich in clotting factors like fibrinogen, factors V and VIII, which are crucial in maintaining proper blood clotting function. Whole blood (Choice A) is not typically used to correct coagulopathy and is more suitable for situations requiring both volume and oxygen-carrying capacity. Platelets (Choice B) are indicated for thrombocytopenia, not for correcting coagulation factors. Packed red blood cells (Choice D) are used to increase oxygen-carrying capacity in cases of anemia, not for correcting coagulopathy.

3. A client with a history of preterm labor is reviewing a new prescription for Terbutaline. Which of the following client statements indicates understanding of the teaching?

• A. I will increase my daily fluid intake to 3 quarts.
• B. I can increase my activity now that I've started on this medication.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. This response demonstrates the client's understanding of the importance of monitoring contractions and seeking appropriate medical attention. Choices A, B, and D are incorrect because increasing fluid intake, increasing activity, or assuming the medication will prevent preterm labor are not relevant actions in managing preterm labor or taking Terbutaline.

4. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

5. A client with heart failure is prescribed digoxin. Which statement by the client indicates an adverse effect of the medication?

• A. I can walk a mile a day.
• B. I've had a backache for several days.
• C. I am urinating more frequently.
• D. I feel nauseated and have no appetite.

Correct answer: D

Rationale: Nausea and loss of appetite are common early signs of digoxin toxicity, indicating an adverse effect of the medication. These symptoms should be reported to the healthcare provider immediately for further evaluation and management.

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