A nurse is admitting a client who has acute heart failure. Which of the following prescriptions from the provider should the nurse anticipate?

Provide the client with a 4g sodium diet.

Ambulate the client every 4 hr while awake.

Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr.

Administer enalapril 2.5 mg PO twice daily.

Answer and Explanation

The Correct Answer is D

A) Provide the client with a 4g sodium diet: This is incorrect. Clients with acute heart failure typically require a low-sodium diet (often less than 2g per day) to help manage fluid retention and reduce workload on the heart.

B) Ambulate the client every 4 hr while awake: While mobility is important, the frequency and timing of ambulation in clients with acute heart failure should be carefully considered based on their stability and fatigue level. It may not be appropriate to ambulate every 4 hours.

C) Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr: This is generally not appropriate for clients with acute heart failure due to the risk of fluid overload. Instead, fluid management often involves restricting IV fluids and closely monitoring fluid balance.

D) Administer enalapril 2.5 mg PO twice daily: This prescription is appropriate. Enalapril, an ACE inhibitor, is commonly used to manage heart failure by reducing afterload and improving cardiac output. It helps alleviate symptoms and improve quality of life in heart failure patients.

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Correct Answer is D

Explanation

A. Bradypnea: This refers to a slower than normal respiratory rate, which is not a typical manifestation of pulmonary congestion. In fact, pulmonary congestion often leads to tachypnea (increased respiratory rate).

B. Jugular vein distention: This is more indicative of right-sided heart failure or fluid overload rather than left-sided heart failure, where the primary issue is related to pulmonary congestion.

C. Weight gain: While weight gain can occur due to fluid retention in heart failure, it is not specific to pulmonary congestion and can be seen in both left-sided and right-sided heart failure.

D. Frothy, pink sputum: This is a classic manifestation of pulmonary congestion and indicates the presence of fluid in the lungs, often seen in left-sided heart failure. The pink color is due to the presence of blood, which may leak into the alveoli due to increased pressure. This finding is critical and should be closely monitored.

A. "The client is exceptionally clingy to others." B. "The client exhibits impulsive behavior." C. "The client is overly concerned about minor details." D. "The client might act seductively."

Correct Answer is B

Explanation

A) "The client is exceptionally clingy to others.": While individuals with borderline personality disorder may have intense relationships, they are not typically described as "clingy" in the same way as those with dependent personality disorder. Instead, they may exhibit a fear of abandonment that leads to tumultuous relationships.

B) "The client exhibits impulsive behavior.": This statement accurately reflects a key characteristic of borderline personality disorder. Clients often engage in impulsive behaviors that can be self-destructive, such as spending sprees, substance abuse, or risky sexual activities. This impulsivity is a hallmark feature of the disorder.

C) "The client is overly concerned about minor details.": This behavior is more characteristic of obsessive-compulsive personality disorder rather than borderline personality disorder. Individuals with borderline personality disorder tend to struggle with emotional regulation and relationships rather than focusing on minor details.

D) "The client might act seductively.": While some individuals with borderline personality disorder may exhibit seductive behavior, it is not a defining characteristic of the disorder. This behavior can be a way to cope with feelings of emptiness or to seek validation, but it is not universally applicable to all clients with borderline personality disorder.

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A nurse is admitting a client who has acute heart failure. Which of the following prescriptions from the provider should the nurse anticipate?

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