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 B

Explanation

A. P wave touching the T wave can indicate an issue but is less urgent than chest pain.

B. Midsternal chest pain could indicate myocardial ischemia or infarction, requiring immediate intervention.

C. Increased urine output is not an urgent concern in this context.

D. Mild orthostatic hypotension is not as urgent as chest pain.

A. Apply a paper bag over the clients nose and mouth. B. Administer 50 mL of 20% glucose and 20 units of regular insulin. C. Administer 50 mL of sodium bicarbonate intravenously. D. Apply oxygen by mask or nasal cannula.

Correct Answer is D

Explanation

A. Appling a paper bag over the client's nose and mouth is used for hyperventilation or respiratory alkalosis, not for respiratory acidosis. In this case, it would worsen the client’s condition by increasing CO2 retention.

B. Administering 50 mL of 20% glucose and 20 units of regular insulin is appropriate for hyperkalemia or diabetic ketoacidosis, not respiratory acidosis following a seizure.

C. Administering 50 mL of sodium bicarbonate intravenously is used for severe metabolic acidosis. This client’s acidosis is primarily respiratory in origin, making this choice inappropriate.

D. Applying oxygen by mask or nasal cannula helps correct the low oxygen levels and supports respiration post-seizure.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

Correct Answer is B

Explanation

A client has just experienced a 90-second tonic-clonic seizure and has the following arterial blood gas results: pH 7.12, HCO3 22 mEq/L, PaCO2 55 mmHg, PaO2 60 mmHg. Which intervention is the most appropriate?

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 health care provider orders: Epinephrine 0.25 mg IV stat Pharmacy provides: Epinephrine 0.1 mg/mL. How many mL will the nurse prepare to administer? (Round to one decimal place.)

The healthcare provider orders dobutamine at 12 mcg/kg/min. The client weighs 75 kg. The pharmacy provides 250 mL of D5W with 1 g of dobutamine. How many mL/hr should the IV pump be programmed for? (Round to a whole number.)

The new graduate nurse is assessing a client with an unrepaired abdominal aortic aneurysm. What assessment technique requires further education by the supervising nurse?

After the nurse has taught the client with a newly diagnosed sexually transmitted infection about expedited partner therapy, which client statement indicates that teaching has been effective?

Which client should the nurse assign as a roommate for a client who has aplastic anemia?

A nurse is reviewing the chart of a new client in the family medicine clinic and notes that the client is identified as "George Smith." The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?