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 D

Explanation

Choice A rationale

A QRS duration of 0.30 seconds is abnormally long. The normal QRS duration is 0.06 to 0.12 seconds, indicating this is not normal sinus rhythm.

Choice B rationale

An inverted T wave is not a characteristic of normal sinus rhythm. It may indicate ischemia or other cardiac abnormalities.

Choice C rationale

A P-R interval of 0.32 seconds is prolonged. The normal P-R interval is 0.12 to 0.20 seconds, thus indicating an abnormal rhythm.

Choice D rationale

The P wave falling before the QRS complex is a key characteristic of normal sinus rhythm, representing the orderly conduction of electrical impulses from atria to ventricles. .

A. Apply cold therapy to the affected leg. B. Monitor Homan’s sign. C. Obtain a venous duplex ultrasound. D. Obtain impedance plethysmography.

Correct Answer is C

Explanation

Choice A rationale

Cold therapy is used for acute injuries to reduce swelling and pain but is not recommended for deep vein thrombosis (DVT) as it can cause vasoconstriction and worsen the condition.

Choice B rationale

Homan's sign is an outdated diagnostic tool for DVT as it is not reliable or specific and can result in false positives or negatives, thus not recommended for diagnosis.

Choice C rationale

Venous duplex ultrasound is the gold standard for diagnosing DVT as it visualizes blood flow and identifies thrombi within the veins, providing accurate and non-invasive detection.

Choice D rationale

Impedance plethysmography measures changes in blood volume but is less accurate than venous duplex ultrasound, and its use has declined in favor of more reliable imaging techniques.

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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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