A home care visiting nurse suspects that an older adult client is developing chronic renal disease. Since the client has no history of cardiovascular disease, what data should the nurse assess further?

Reports of joint pain.

Increase in appetite.

Progressive edema.

Recent increase in thirst.

Answer and Explanation

The Correct Answer is C

A. Reports of joint pain: Joint pain is more indicative of musculoskeletal issues rather than chronic renal disease. While joint pain can occur in some types of kidney disease, progressive edema is a more specific symptom.

B. Increase in appetite: An increase in appetite is not typically associated with chronic renal disease. Instead, clients with kidney disease may experience a decrease in appetite due to various factors such as nausea, vomiting, and changes in taste.

C. Progressive edema: Progressive edema, especially in the lower extremities and around the eyes (periorbital edema), can be a significant indicator of declining kidney function. It results from fluid retention due to impaired kidney filtration.

D. Recent increase in thirst: While increased thirst can be a symptom of chronic renal disease, it is not as specific as progressive edema. Increased thirst may occur due to other conditions or factors such as diabetes mellitus or dehydration.

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Correct Answer is A

Explanation

A. The client has a history of bronchial asthma: Propranolol is a non-selective beta-blocker and can potentially exacerbate bronchospasm in individuals with asthma due to its beta-blocking effects on beta-2 receptors in the bronchioles. Therefore, this finding should be reported to the provider for further assessment and consideration of alternative medications.

B. The client has a history of migraine headaches: Propranolol is commonly used prophylactically to prevent migraine headaches, so this finding is not a contraindication for its use and does not require immediate reporting to the provider.

C. The client has a history of hypertension: Propranolol is often prescribed for hypertension, so this finding is expected and not a cause for concern.

D. The client has a history of hypothyroidism: While propranolol can affect thyroid function tests, a history of hypothyroidism alone is not a contraindication for its use, and it does not

require immediate reporting to the provider. However, thyroid function should be monitored during therapy.

A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain B. Bumetanide 1 mg IV bolus every 12 hr C. Laboratory testing of serum potassium upon admission D. 0.9% normal saline IV at 75 mL/hr

Correct Answer is B

Explanation

A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain: This prescription is appropriate for managing pain associated with acute heart failure and MI.

B. Bumetanide 1 mg IV bolus every 12 hr: Bumetanide is a loop diuretic commonly used in heart failure to reduce fluid overload. However, the frequency of administration (every 12 hours) may not be sufficient for managing acute heart failure, where more frequent dosing may be necessary initially.

C. Laboratory testing of serum potassium upon admission: This is a routine and appropriate order to monitor electrolyte balance, especially with the use of diuretics.

D. 0.9% normal saline IV at 75 mL/hr: This is a maintenance IV fluid rate that may be appropriate depending on the client's fluid status. However, it does not directly address acute heart failure.

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A home care visiting nurse suspects that an older adult client is developing chronic renal disease. Since the client has no history of cardiovascular disease, what data should the nurse assess further?

Nursing Test Bank

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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