A patient arrives to the emergency department with crackles audible in the bilateral lungs, and 3+ pitting edema to his lower extremities. The provider orders furosemide 40 mg slow IV push to be given one time. Which of the following assessment findings requires the nurse to hold the medication and contact the provider for further instructions?

Sodium 149 mEq/L

Blood pressure 90/53 mmHg

Client is incontinent of urine

Potassium 53 mEq/L

Answer and Explanation

The Correct Answer is B

A.   Hypernatremia can indicate dehydration or other electrolyte imbalances. Furosemide can further affect electrolyte balance, especially sodium and potassium. However, this sodium level is only slightly elevated and may not necessarily require immediate action regarding furosemide administration.
B.   Furosemide is a diuretic that can further decrease blood pressure due to its effects on fluid volume reduction. Administering it to a patient with already low blood pressure could potentially lead to significant hypotension and compromise perfusion to vital organs.
C.   While incontinence itself may not directly contraindicate furosemide administration, it could indicate underlying issues such as bladder dysfunction or fluid overload that need further evaluation. This finding alone would not necessarily require holding the medication, but it warrants further assessment and consideration in the clinical context.
D.   Normal serum potassium levels typically range from 3.5-5.0 mEq/L. A level of 5.3 mEq/L indicates hyperkalemia (elevated potassium). While this potassium level is mildly elevated, it would not be a reason on its own to hold furosemide. Monitoring potassium levels closely and potentially adjusting potassium

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Correct Answer is C

Explanation

A. This function is typically managed by medications such as beta-blockers or calcium channel blockers, which help reduce heart rate and myocardial oxygen demand. Rosuvastatin does not directly affect heart rate or myocardial oxygen demand.
B. Medications like aspirin or other antiplatelet agents are used to inhibit platelet aggregation and reduce the risk of thrombus formation. Rosuvastatin is not primarily indicated for this purpose.
C. This is the correct rationale for prescribing rosuvastatin in a client with chronic stable angina. High LDL cholesterol levels contribute to the development and progression of atherosclerosis, which narrows coronary arteries and leads to angina. By lowering LDL cholesterol levels, rosuvastatin helps slow down the progression of atherosclerosis and reduces the risk of cardiovascular events, including angina.
D. Acute episodes of angina are typically managed with short-acting nitrates or other medications that dilate coronary arteries to improve blood flow to the heart muscle. Rosuvastatin does not provide immediate relief of angina symptoms.

A. Medicare covers people under 65-years who have end-stage renal disease. B. Low-income people who have Medicare can also qualify for Medicaid. C. People who qualify for Medicare will have no out-of-pocket medical expenses. D. Medicare is federally-funded health insurance for people 65-years or older.

Correct Answer is C

Explanation

A. Medicare does cover individuals under 65 years old who have end-stage renal disease (ESRD) and meet certain criteria.
B. There are programs that allow individuals with both Medicare and low income to qualify for Medicaid, which can help cover additional healthcare costs that Medicare may not fully cover.
C. While Medicare does provide significant coverage for healthcare services, it is not entirely free of out- of-pocket costs. Medicare Part A typically covers hospital stays, skilled nursing facility care, hospice, and some home health care services with no premiums for most people.
D. Medicare is indeed federally-funded health insurance primarily for individuals aged 65 and older. It also covers certain younger individuals with disabilities and those with ESRD.

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Naxlex Comprehensive Predictor Exams

A client who has been diagnosed with chronic stable angina is placed on multiple medications to manage the condition. The nurse understands that the client is receiving rosuvastatin for which reason?

Correct Answer is C

Explanation

A nurse manager is discussing social services for older adults during a staff meeting in a long- term acute care (LTAC) facility. Which statement about Medicare made by one of the employees requires correction by the nurse manager?

Correct Answer is C

Explanation

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