A client is seen in the emergency department with a heart failure exacerbation due to noncompliance with medications and fluid restrictions. Which key diagnostic result should the nurse assess to determine the severity of the client's heart failure exacerbation?
Blood urea nitrogen (BUN)
Troponin
B-type natriuretic peptide (BNP)
Electrocardiogram
The Correct Answer is C
A. Elevated BUN can indicate kidney dysfunction but is not specific for assessing heart failure severity.
B. Elevated troponin levels indicate myocardial injury or infarction, not heart failure exacerbation.
C. B-type natriuretic peptide (BNP) levels are directly correlated with the severity of heart failure, as they are released in response to ventricular volume expansion and pressure overload.
D. An electrocardiogram (ECG) can show arrhythmias or ischemia but does not directly measure heart failure severity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.
Correct Answer is ["A","D","F","G"]
Explanation
A. Administering furosemide 40 mg via IV push once is appropriate for treating fluid overload, as evidenced by pitting edema and crackles in the lungs, common in heart failure.
B. An IV infusion of normal saline (NS) at 150 mL/hr is not appropriate for this client as it can exacerbate fluid overload and worsen heart failure symptoms.
C. Administering digoxin 0.25 mg via IV push NOW may be indicated, but considering the client's low pulse rate (55/min), caution is necessary due to the risk of digoxin toxicity and bradycardia.
D. Monitoring daily weights is crucial for assessing fluid balance in heart failure patients and detecting any changes in fluid status.
E. Calling a code STEMI is not appropriate as the client does not exhibit signs of a STEMI; troponin levels are not elevated, and there is no indication of an acute myocardial infarction.
F. Monitoring strict intake and output helps in managing fluid balance and ensuring accurate assessment of the client's fluid status.
G. Preparing the client for an echocardiogram is appropriate to assess cardiac function and evaluate the severity of heart failure.
H. Radiofrequency catheter ablation is not indicated for this client as it is typically used to treat arrhythmias, not heart failure or fluid overload.
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