A client was admitted to the intensive care unit after having an abdominal aortic aneurysm resection. The client's cardiac monitor shows a heart rate of 110. The clients hemodynamic monitoring shows a Central Venous Pressure (CVP): 1 mmHg and a Pulmonary Arterial Wedge Pressure (PAWP): 3 mmHg. Which health care provider order would the nurse anticipate receiving?

Monitor hemodynamic monitoring parameters again in one hour.

Administer Furosemide (Lasix) 20mg IVP.

Decrease IV Fluids to 75ml/hr and recheck hemodynamic parameters.

Administer 0.9% Normal Saline @ 150ml/hr

Answer and Explanation

The Correct Answer is D

A. Although monitoring hemodynamic parameters is important, this option does not address the immediate issue of low preload, as indicated by the low CVP and PAWP, suggesting hypovolemia.

B. Furosemide is a diuretic and would further decrease intravascular volume, which is inappropriate given the signs of hypovolemia.

C. Decreasing IV fluids would exacerbate the low preload and worsen the client's condition by reducing intravascular volume even further.

D. Administering 0.9% Normal Saline @ 150 mL/hr is the most appropriate intervention. The low CVP and PAWP indicate hypovolemia, and increasing fluid administration will help to increase the preload, thereby improving the client's hemodynamic status.

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Correct Answer is A

Explanation

A. The primary concern in this scenario is urinary retention, which can lead to kidney dysfunction (indicated by elevated BUN and creatinine). The priority intervention is relieving the retention by inserting a Foley catheter, which will help restore normal urinary output and prevent further complications.

B. MRI is not an immediate priority when the client is at risk for kidney damage due to urinary retention.

C. While IV fluids may be necessary, the first priority is relieving the obstruction causing urinary retention.

D. Drawing blood is important for assessing the client's condition but is not as urgent as managing urinary retention.

A. 2+ bilateral peripheral edema B. Heart rate 59 beats/min C. Temperature of 96 F D. Muffled heart sounds

Correct Answer is D

Explanation

A. Bilateral peripheral edema can occur after heart catheterization but is not as immediately life-threatening as cardiac tamponade.

B. A heart rate of 59 beats/min may be concerning, but bradycardia alone is not as immediately urgent as signs of cardiac tamponade.

C. A temperature of 96°F is low, but this is more of a concern for hypothermia or post-procedural effects and is not as urgent as muffled heart sounds indicating tamponade.

D. Muffled heart sounds can indicate cardiac tamponade, a medical emergency. Immediate intervention is required to relieve the pressure on the heart, which may involve pericardiocentesis to drain the fluid or blood.

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Naxlex Comprehensive Predictor Exams

A client who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine levels. Which prescribed therapy should the nurse implement first?

Correct Answer is A

Explanation

The nurse is caring for a client after a heart catheterization. What complication must the nurse intervene for immediately?

Correct Answer is D

Explanation

The nurse assesses a client who just returned to the recovery area after undergoing a balloon angioplasty to improve circulation to the left leg. What assessment finding is the most concerning?

The nurse is providing preoperative education to a client prior to having an orchiectomy for testicular cancer. What statement by the client indicates the need to review the information?

The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding?

Which information about continuous bladder irrigation will the nurse teach to a client who is being admitted for a transurethral resection of the prostate (TURP)?

After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

Which assessment finding in a 36-year-old client is most indicative for further evaluation?

After receiving change-of-shift report about the following four clients, which client should the nurse assess first?