The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV. Which parameter would the nurse use to best evaluate if the client is responding to this medication?

Serum sodium level is 135 mEq/L (normal 135-145mEq/L)

Respiratory rate of 16/minute

Blood pressure reading of 120/80

Urine output 120 mL one hour following administration

Answer and Explanation

The Correct Answer is B

A.   Serum sodium level of 135 mEq/L (normal 135-145mEq/L) - Although important, sodium levels do not directly assess the effectiveness of furosemide in relieving fluid overload.
B.   Respiratory rate of 16/minute - A decrease in respiratory rate following the administration of furosemide indicates that the client is improving, as furosemide works to reduce fluid overload and ease breathing.
C.   Blood pressure reading of 120/80 - While blood pressure may be influenced by fluid status, it is not the best indicator for the effectiveness of diuretics in this case.
D.   Urine output 120 mL one hour following administration - While urine output is important, a single hour’s output may not show the full effectiveness of the diuretic, and output can vary depending on the client’s hydration status.

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Correct Answer is A

Explanation

A. Giving away valued possessions - This is a classic sign of suicidal ideation, as individuals may feel they no longer need their belongings or want to say goodbye to loved ones in a symbolic way.
B. Engaging in high-risk behaviors - While high-risk behaviors can be a sign of depression, they are not necessarily indicative of suicidal thoughts.
C. Talkative, with pressured speech - This could be indicative of a manic episode or high anxiety, but it is not a common sign of suicidal behavior.
D. Guilt, decreased self-esteem - Although guilt and low self-esteem are symptoms of depression, they do not directly indicate suicidal thoughts or behaviors.

A. Administer timolol eye drops to both eyes B. Insert an indwelling catheter C. Administer an antidiarrheal medication D. Provide frequent oral care

Correct Answer is D

Explanation

A. Timolol eye drops are not indicated following the administration of atropine, as atropine has no effect on intraocular pressure.
B. Inserting an indwelling catheter is not necessary for the administration of atropine, which is used to treat bradycardia, not urinary retention.
C. Administering an antidiarrheal medication is unrelated to atropine administration; atropine typically causes dry mouth rather than diarrhea.
D. Atropine is an anticholinergic medication that decreases saliva production, which can lead to dry mouth and discomfort. Frequent oral care is important to prevent oral mucosal irritation and discomfort for the client.

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			Male: 14- 17.3 g/dL
Hematocrit	26%	24%	Female: 36%-48% Male: 42%-52%
Platelets	35,000mm3	20,000mm3	150,000- 450,000mm3
RBC	4.5 mm3	3mm3	Female: 4.01-5.51 million/mm3 Male: 4.51-

The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV. Which parameter would the nurse use to best evaluate if the client is responding to this medication?

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Naxlex Comprehensive Predictor Exams

Which behavior observed by the nurse causes a suspicion that a depressed client may be suicidal?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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