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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Cardiac enzymes, such as troponins, are specific to heart muscle damage. They are not used to diagnose pulmonary congestion, which is typically assessed with a chest X-ray and clinical evaluation.
Choice B rationale
Cardiac enzyme levels indicate the extent of myocardial damage but do not specify the location of the MI. Imaging techniques like ECG or coronary angiography are used to identify the MI location.
Choice C rationale
Elevated cardiac enzyme levels, particularly troponins, indicate myocardial cell injury and help determine the severity of heart tissue damage. Normal troponin I levels are usually less than 0.04 ng/mL.
Choice D rationale
Cardiac enzyme studies do not provide information about heart structure or valve mobility. Echocardiography is the appropriate test for assessing heart structure and valve function.
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.
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