After administering furosemide 20 mg PO to a client diagnosed with hypertension and peripheral edema, which finding would best indicate that the therapeutic effect of the medication has been achieved?

Blood pressure remains stable at 130/86 mmHg.

Lungs are clear to auscultation.

Serum potassium has decreased from 4.0 to 3.5 mEq/L.

Urine output increases from 30 mL per hour to 100 mL per hour.

Answer and Explanation

The Correct Answer is D

Choice A Reason
While maintaining a stable blood pressure is important for a client with hypertension, furosemide is primarily a diuretic, and its therapeutic effect is to reduce fluid overload, not directly to stabilize blood pressure. Therefore, this finding alone does not best indicate the therapeutic effect of furosemide.

Choice B Reason
Clear lungs upon auscultation suggest an improvement in pulmonary edema, which can be associated with fluid overload in conditions such as heart failure. However, for a client with peripheral edema, the primary therapeutic goal of furosemide is to reduce the excess fluid in the extremities, not just the lungs.

Choice C Reason
A decrease in serum potassium is a known side effect of furosemide due to its action on the kidneys, leading to increased excretion of potassium. While it's important to monitor for hypokalemia, a decrease in potassium does not directly indicate the therapeutic effect of reducing edema.

Choice D Reason
An increase in urine output from 30 mL per hour to 100 mL per hour is a direct indication that furosemide is achieving its therapeutic effect. Furosemide is a loop diuretic that increases urine production to help the body eliminate excess fluid, thereby reducing edema associated with conditions like hypertension.

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Correct Answer is C

Explanation

Choice A Reason:
A blood glucose level of 80 mg/dL before eating falls within the normal fasting blood glucose range, which is between 70 mg/dL to 110 mg/dL. Therefore, this finding is not a priority concern for a client taking prednisone.

Choice B Reason:
Gaining 5 pounds over 7 months is not typically a priority concern unless it is sudden or unexplained. Prednisone can cause fluid retention and weight gain as a common side effect, but this gradual weight change does not indicate an immediate health risk.

Choice C Reason:
Waking up with a fever is a priority finding as it may indicate an infection. Patients on prednisone are at increased risk of infections due to its immunosuppressive effects¹. Fever could also signify an exacerbation of inflammatory bowel disease or other complications.

Choice D Reason:
While insomnia is a common side effect of prednisone and can impact quality of life, it is not typically a priority over signs that could indicate infection or exacerbation of the underlying condition

A. Avoiding frustrating the client by performing ADLs for the client. B. Telling jokes or riddles and discussing new items. C. Bringing new topics and options to the client's attention. D. Assisting the client to perform simple tasks by giving step-by-step directions.

Correct Answer is D

Explanation

Choice A Reason:
Avoiding frustration by performing activities of daily living (ADLs) for the client may seem helpful, but it can actually lead to increased dependency and a faster decline in the ability to perform these tasks. It is important to encourage independence as much as possible.

Choice B Reason:
Telling jokes or riddles and discussing new items might provide temporary entertainment but does not necessarily help a client with dementia function better in their environment. It could also potentially cause confusion or frustration if the client does not understand or remember the context.

Choice C Reason:
Bringing new topics and options to the client's attention can be overwhelming and may contribute to confusion. Clients with dementia benefit from consistency and routine, which helps them feel more secure and oriented.

Choice D Reason:
Assisting the client to perform simple tasks by giving step-by-step directions is a beneficial intervention. It supports the client's ability to maintain independence and function within their environment for as long as possible. This approach aligns with the goal of maximizing the client's abilities and fostering a sense of accomplishment.

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After administering furosemide 20 mg PO to a client diagnosed with hypertension and peripheral edema, which finding would best indicate that the therapeutic effect of the medication has been achieved?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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