A 72-year-old patient with a history of systolic heart failure is admitted with worsening dyspnea, orthopnea, and peripheral edema. The following orders are written. Which action should the nurse take first?

Educate the patient about low-sodium diet and daily weight monitoring

Draw blood for B-type natriuretic peptide (BNP) and electrolyte levels.

Administer furosemide 40 mg IV push

Place the patient on continuous cardiac monitoring

Answer and Explanation

The Correct Answer is C

A. Education is important but not a priority when the patient is experiencing acute symptoms such as worsening dyspnea and edema.
B. Drawing blood for BNP and electrolytes is part of the diagnostic process but does not immediately relieve symptoms or prevent complications.
C. Administering furosemide IV push addresses the most immediate concern: relieving fluid overload, which is causing dyspnea, orthopnea, and edema. It reduces preload and improves breathing, making it the priority action.
D. Continuous cardiac monitoring is appropriate, especially for a patient with heart failure, but relieving fluid overload takes precedence to stabilize the patient’s respiratory status.

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Correct Answer is A

Explanation

A. A phlebotomist who collects blood from clients who have HIV — Blood is the primary route of HIV transmission in healthcare settings. A phlebotomist handling blood samples is at the highest occupational risk, especially if a needle-stick injury occurs.
B. An occupational therapist who works with a client who has HIV — Casual contact during therapy sessions does not pose a significant risk for HIV transmission.
C. A personal trainer who works with a client who has HIV — HIV is not spread through sweat or casual physical contact, so the risk here is extremely low.
D. A nurse who works for an insurance company and collects urine samples from clients who have HIV — HIV is not transmitted through urine unless it contains visible blood, and even then, the risk is very low with proper precautions.

A. "A condom needs to be used for intercourse but is not necessary for oral contact." B. "If I use condoms consistently, they are very effective in preventing transmission." C. "Lambskin condoms are the most effective in preventing transmission? D. "Condoms are not effective during anal intercourse.

Correct Answer is B

Explanation

A. "A condom needs to be used for intercourse but is not necessary for oral contact." — HIV can be transmitted through oral sex, although the risk is lower. Condoms or other barriers (like dental dams) are recommended for all forms of sexual contact.
B. "If I use condoms consistently, they are very effective in preventing transmission." —Consistent and correct use of condoms significantly reduces the risk of HIV transmission during all types of sexual activity.
C. "Lambskin condoms are the most effective in preventing transmission?" — Lambskin condoms can prevent pregnancy but do not effectively block viruses like HIV due to their porous nature. Latex or synthetic condoms are recommended.
D. "Condoms are not effective during anal intercourse." — Condoms are effective during anal intercourse when used correctly, and they are strongly recommended because anal sex carries a higher risk for HIV transmission.

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A 72-year-old patient with a history of systolic heart failure is admitted with worsening dyspnea, orthopnea, and peripheral edema. The following orders are written. Which action should the nurse take first?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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