A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?

Obtain daily weights of the client.

Assess for acid-base balance.

Assess the client's serum creatinine.

Auscultate heart sounds.

Answer and Explanation

The Correct Answer is A

Choice A reason: Obtaining daily weights of the client is the best action to assess the therapeutic effect of furosemide in managing early chronic kidney disease. Daily weights provide valuable information about fluid balance and the effectiveness of the diuretic in reducing fluid retention. Consistent weight monitoring helps determine if the medication is achieving its goal of managing fluid overload, which is a common issue in CKD patients.

Choice B reason: Assessing acid-base balance is important in managing CKD, but it is not the primary action to assess the therapeutic effect of furosemide. While diuretics can influence electrolyte levels and acid-base balance, monitoring fluid status through daily weights is more directly related to evaluating the effectiveness of the medication.

Choice C reason: Assessing the client's serum creatinine is crucial for monitoring kidney function and progression of CKD. However, it is not the primary action to determine the therapeutic effect of furosemide. The focus of furosemide therapy is to manage fluid balance, and daily weights provide a more immediate and relevant assessment of this effect.

Choice D reason: Auscultating heart sounds is part of a comprehensive assessment of a CKD patient, but it is not the best action to evaluate the therapeutic effect of furosemide. Heart sounds can provide information about cardiac function and potential complications, but they do not directly measure the effectiveness of fluid management achieved by the diuretic.

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Correct Answer is B

Explanation

Choice A reason: Encouraging the patient to continue an exercise routine such as weightlifting is not appropriate for a patient with esophageal varices. Weightlifting and other strenuous activities can increase intra-abdominal pressure, which may lead to the rupture of the varices and cause severe bleeding.

Choice B reason: Advising the patient to avoid straining at stools is the correct intervention. Straining during bowel movements can increase intra-abdominal pressure and the risk of rupturing the esophageal varices. The nurse should encourage the patient to maintain soft stools through a high-fiber diet, adequate hydration, and possibly stool softeners to prevent straining.

Choice C reason: Providing hot liquids as desired is not recommended for patients with esophageal varices. Hot liquids can cause vasodilation and potentially increase the risk of bleeding from the varices. Patients should be advised to consume beverages at moderate temperatures.

Choice D reason: Advising the patient to limit themselves to one alcoholic drink per day is not appropriate. Alcohol consumption can worsen liver disease, increase portal hypertension, and exacerbate esophageal varices. Patients with esophageal varices should be advised to avoid alcohol completely to reduce the risk of complications.

A. Finger-stick glucose. B. Blood cultures x2. C. Tylenol 650 mg PO. D. Vancomycin 760 mg IV.

Correct Answer is B

Explanation

Choice A reason: Finger-stick glucose is important for monitoring blood sugar levels, especially in septic patients who may develop hyperglycemia. However, it is not the highest priority compared to obtaining blood cultures and administering antibiotics.

Choice B reason: Obtaining blood cultures x2 is the first priority in managing a patient with sepsis. Identifying the causative organism and determining antibiotic susceptibility is crucial for guiding effective treatment. Blood cultures should be obtained before administering antibiotics to ensure accurate results.

Choice C reason: Tylenol (acetaminophen) 650 mg PO may be given to reduce fever and provide comfort, but it is not the highest priority in the initial management of sepsis. Immediate diagnostic and therapeutic interventions are more critical.

Choice D reason: Vancomycin 760 mg IV is an important antibiotic for treating sepsis, especially if a resistant organism is suspected. However, it should be administered after blood cultures are obtained to avoid contaminating the cultures and ensuring accurate identification of the causative organism.

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A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Considering the patient's esophageal varices, which of the following nursing interventions would be appropriate in your care of the patient?

Correct Answer is B

Explanation

The nurse is caring for a newly admitted patient with sepsis and has received orders from the physician. What order should the nurse implement first?

Correct Answer is B

Explanation

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