A nurse is caring for a client with left-sided heart failure. To reduce fluid volume excess, which of the following should the nurse anticipate using?
Anticoagulants
Antiembolism stockings
Oxygen
Diuretics
The Correct Answer is D
Choice A reason : Anticoagulants are medications that prevent blood clots. They are not typically used to manage fluid volume excess in left-sided heart failure. Instead, they may be used if the patient has an increased risk of clotting due to reduced mobility or atrial fibrillation, which can be associated with heart failure⁵.
Choice B reason : Antiembolism stockings are used to prevent deep vein thrombosis (DVT) and are not directly related to the management of fluid volume excess. They may be used in heart failure patients to prevent DVT due to reduced mobility but do not aid in fluid reduction⁵.
Choice C reason : Oxygen therapy can be used in left-sided heart failure to alleviate symptoms of dyspnea due to pulmonary congestion. However, it does not directly reduce fluid volume excess. It is a supportive treatment to ensure adequate oxygenation⁵.
Choice D reason : Diuretics are the primary treatment for reducing fluid volume excess in left-sided heart failure. They work by increasing urine output, which helps to reduce the volume of fluid in the body and alleviate symptoms such as pulmonary edema and peripheral edema⁵.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason : Bradykinesia refers to the slowness of movement and is commonly associated with Parkinson's disease, not meningitis. It is characterized by a gradual loss of spontaneous movement and can affect the ability to initiate and continue movements¹.
Choice B reason : Brudzinski's sign is a clinical sign that suggests meningitis when neck flexion causes reflex flexion of the hips and knees. It occurs due to meningeal irritation caused by spinal cord movement or nerves against the meninges¹. This sign is considered positive when passive flexion of the neck results in reflex flexion of the hips and knees, indicating meningeal irritation².
Choice C reason : Kernig's sign is another clinical sign used to evaluate for meningitis. It involves extending and straightening one knee while the individual lies on their back with their hips and knees bent at a 90-degree angle. A positive Kernig’s sign indicates pain or resistance when the leg is extended, which suggests meningitis³. However, it is not the condition described in the scenario.
Choice D reason : Nuchal rigidity is an inability to flex the neck forward due to rigidity of the neck muscles. While it is a sign of meningitis, it does not involve the involuntary flexion of the legs as described in the scenario. Nuchal rigidity is typically assessed by attempting to flex the patient's neck forward while they are in a supine position⁴.
Correct Answer is A
Explanation
Choice A reason : Standard precautions are the primary strategy for the prevention and control of hepatitis C virus (HCV) transmission. According to the Centers for Disease Control and Prevention (CDC), standard precautions include hand hygiene and the use of personal protective equipment to prevent contact with blood and other potentially infectious materials¹. Since HCV is primarily transmitted through blood-to-blood contact, standard precautions are sufficient for routine care of patients with hepatitis C².
Choice B reason : Airborne precautions are not necessary for hepatitis C as it is not spread through the air. These precautions are used for diseases that are transmitted through airborne droplet nuclei or dust particles containing the infectious agent, such as tuberculosis, measles, or chickenpox¹.
Choice C reason : Droplet precautions are also not required for hepatitis C because it is not spread through droplets in the air. Droplet precautions are used for infections that can be transmitted through large droplets expelled during coughing, sneezing, talking, or during procedures such as suctioning and bronchoscopy¹.
Choice D reason : Contact precautions are not specifically required for hepatitis C unless there is a risk of blood contamination. Contact precautions are typically used for infections that are spread by direct or indirect contact with the patient or the patient's environment, such as gastrointestinal, respiratory, skin, or wound infections¹.
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