A nurse is preparing to administer bumetanide to a client who has heart failure. Which of the following findings indicates effectiveness of the medication?

Bounding radial pulse

Alert and oriented to time, place, and person

Lung sounds clear on auscultation

Bowel sounds present in four quadrants on auscultation

Answer and Explanation

The Correct Answer is C

Rationale:

A. Bounding radial pulse: A bounding radial pulse is not an indication of the effectiveness of bumetanide. It may suggest fluid overload or increased blood pressure, which is contrary to the goal of diuretic therapy in heart failure.

B. Alert and oriented to time, place, and person: While this indicates the client is neurologically stable, it does not specifically reflect the effectiveness of bumetanide, which is focused on reducing fluid overload and improving lung and cardiac function.

C. Lung sounds clear on auscultation: Clear lung sounds indicate that fluid buildup in the lungs, which is common in heart failure, has improved. Bumetanide is a diuretic that reduces fluid overload, and clear lung sounds are a key sign that the medication is effectively treating the client's condition.

D. Bowel sounds present in four quadrants on auscultation: While normal bowel sounds are important, they are not directly related to the effectiveness of bumetanide. Bumetanide’s primary effect is on fluid balance and lung function, not gastrointestinal function.

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Correct Answer is A

Explanation

Rationale:

A. Dyspnea at rest: Dyspnea at rest is a sign of advanced COPD, indicating that the client is experiencing significant respiratory difficulty. Pulmonary rehabilitation can help improve exercise tolerance and breathing, making this an appropriate reason for referral.

B. Pursed-lip breathing: Pursed-lip breathing is a technique often used by clients with COPD to help manage shortness of breath. It is not an indication for pulmonary rehabilitation, but rather a self-management strategy.

C. Clubbing of the fingers: Clubbing of the fingers can be a sign of chronic hypoxia and is commonly seen in advanced COPD. However, it does not directly indicate the need for pulmonary rehabilitation, although the condition may benefit from comprehensive care.

D. SPO2 90%: A SpO2 of 90% is low but not necessarily an indication for referral to pulmonary rehabilitation. It is important to monitor oxygen levels, but this alone does not trigger the need for rehabilitation.

A. Strict I&O B. Increase fluid intake C. Encourage protein supplements D. Strain all urine

Correct Answer is ["A","D"]

Explanation

Rationale:

A. Strict I&O: Monitoring intake and output is essential due to decreased urination, flank pain, and impaired kidney function. The elevated BUN and creatinine levels suggest renal impairment, and strict I&O helps assess fluid balance.

B. Increase fluid intake: While hydration is important, increasing fluids should be done cautiously due to the client’s impaired kidney function. Given the elevated BUN and creatinine, the kidneys may not manage increased fluids without worsening fluid retention.

C. Encourage protein supplements: Protein supplements are not recommended in kidney dysfunction, as they can worsen renal strain. Elevated BUN and creatinine levels indicate kidney impairment, and protein intake may aggravate the condition.

D. Strain all urine: Straining all urine is necessary to capture any possible kidney stones, blood clots, or debris. The reddish-brown urine and positive blood in the urinalysis suggest hematuria, which may need further investigation.

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A nurse is preparing to administer bumetanide to a client who has heart failure. Which of the following findings indicates effectiveness of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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