A nurse is admitting a client who has acute heart failure following a myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

0.9% normal saline IV at 50 mL/hr continuous.

Laboratory testing of serum potassium upon admission.

Bumetanide 1 mg IV bolus every 12 hr.

Morphine sulfate 2 mg IV bolus every 2 hr PRN pain.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Administering 0.9% normal saline IV at 50 mL/hr continuously in acute heart failure can exacerbate fluid overload, worsening symptoms like pulmonary edema.

Choice B rationale

Serum potassium testing is essential in heart failure management due to potential electrolyte imbalances from medications like diuretics.

Choice C rationale

Bumetanide, a loop diuretic, is used to manage fluid overload in acute heart failure by promoting diuresis and reducing volume overload.

Choice D rationale

Morphine sulfate can help alleviate pain and anxiety in heart failure patients, reducing oxygen demand and improving symptoms.

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Correct Answer is C

Explanation

Choice A rationale

Slow repolarization of ventricular Purkinje fibers is not associated with the P wave. The P wave represents atrial depolarization, which is the electrical activation of the atria.

Choice B rationale

Early ventricular repolarization is represented by the T wave, not the P wave. The P wave specifically reflects atrial depolarization.

Choice C rationale

Atrial depolarization is the correct role of the P wave. It represents the electrical activity that leads to atrial contraction. Normal duration is 0.06 to 0.12 seconds.

Choice D rationale

Ventricular depolarization is represented by the QRS complex. The P wave precedes this and is related to atrial depolarization, not ventricular events.

A. Assess pulses in the client’s affected arm. B. Keep the client NPO for at least 2 hours following the procedure. C. Apply light pressure to the insertion site. D. Encourage the client to ambulate within 30 minutes following the procedure.

Correct Answer is A

Explanation

Choice A rationale

Assessing pulses in the affected arm ensures proper blood flow and identifies potential complications like arterial occlusion following cardiac catheterization. Monitoring for changes can prevent severe outcomes. Normal pulse rates: 60-100 bpm.

Choice B rationale

Keeping the client NPO post-procedure is unnecessary as food and liquids can typically be resumed once the patient is stable, unless specific medical instructions indicate otherwise.

Choice C rationale

Light pressure on the insertion site is insufficient for hemostasis. Firm pressure for 10-15 minutes is necessary to prevent bleeding and hematoma formation, especially in arterial catheterization sites.

Choice D rationale

Immediate ambulation post-cardiac catheterization risks bleeding and hematoma at the insertion site. Bed rest and activity restrictions should be maintained until hemostasis is confirmed, typically for 2-6 hours.

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A nurse is admitting a client who has acute heart failure following a myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

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Naxlex Comprehensive Predictor Exams

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