a nurse is caring for a client who is receiving furosemide for heart failure which of the following findings should the nurse report to the provider

ATI RN

ATI Comprehensive Exit Exam

1. A client is receiving furosemide for heart failure. Which of the following findings should the nurse report to the provider?

A. Weight loss of 0.5 kg (1.1 lb) in 24 hours.
B. Heart rate of 68/min.
C. Potassium level of 3.8 mEq/L.
D. Urine output of 60 mL/hr.

Correct answer: B

Rationale: The correct answer is B. A heart rate of 68/min is lower than expected and should be reported as it may indicate digoxin toxicity. Choices A, C, and D are within normal limits for a client receiving furosemide for heart failure and do not require immediate reporting. Weight loss may be expected due to diuretic therapy, a potassium level of 3.8 mEq/L is within the normal range, and a urine output of 60 mL/hr indicates adequate renal perfusion.

2. A nurse is teaching a prenatal class about infection. Which statement by the client indicates further teaching is required?

A. I can visit someone with chickenpox 5 days after the sores crust.
B. I should avoid eating foods that contain high folic acid.
C. I can clean my cat's litter box during pregnancy.
D. I should wash my hands with hot water for 10 seconds after gardening.

Correct answer: C

Rationale: The correct answer is C because cleaning a cat's litter box during pregnancy can increase the risk of toxoplasmosis, which can be harmful to the developing fetus. Choice A is correct as the statement indicates understanding of the chickenpox transmission timeline. Choice B is also correct as high folic acid foods are beneficial during pregnancy. Choice D is correct as washing hands with hot water after gardening helps prevent infections.

3. Which electrolyte imbalance is most concerning for a patient on furosemide?

A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss through increased urinary excretion, making hypokalemia the most concerning electrolyte imbalance. Hyponatremia (Choice B) is not typically associated with furosemide use. Hyperkalemia (Choice C) is less likely due to furosemide's potassium-wasting effect. Hypercalcemia (Choice D) is not a common electrolyte imbalance seen with furosemide.

4. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

A. Serum calcium
B. Blood glucose
C. Serum protein
D. Serum albumin

Correct answer: D

Rationale: The correct answer is D, Serum albumin. Serum albumin levels are a good indicator of the nutritional effectiveness of total parenteral nutrition (TPN). Monitoring serum albumin levels helps assess the client's overall protein status and nutritional adequacy. Choices A, B, and C are not direct indicators of the effectiveness of TPN therapy. Serum calcium levels may be affected by other factors, blood glucose monitoring is more relevant for clients with diabetes or those receiving insulin therapy, and serum protein is not as specific as serum albumin in evaluating TPN effectiveness.

5. How should a healthcare provider care for a patient with a tracheostomy?

A. Clean the tracheostomy site daily
B. Change the tracheostomy ties daily
C. Suction the tracheostomy regularly
D. Provide humidified oxygen

Correct answer: C

Rationale: Suctioning the tracheostomy regularly is crucial in caring for a patient with a tracheostomy as it helps keep the airway clear of secretions, preventing blockages and potential complications. Cleaning the tracheostomy site daily is important for hygiene but not as critical as regular suctioning. Changing the tracheostomy ties daily may not be necessary unless soiled or loose. Providing humidified oxygen may be part of the care plan but is not as directly related to maintaining the tracheostomy patency as suctioning.