The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient’s most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.1 mEq/L; chloride, 100 mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse’s best action?
Administer Lasix as ordered
Place the patient on oxygen
Hold the Lasix and notify the physician
Begin a 24-hour urine collection
The Correct Answer is C
Choice A reason: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia. The patient’s potassium level (3.1 mEq/L) is below normal (3.5-5.0 mEq/L), indicating hypokalemia, which can cause arrhythmias. Administering Lasix without addressing this could worsen the electrolyte imbalance, making this choice unsafe and incorrect.
Choice B reason: Oxygen administration addresses respiratory issues, not electrolyte imbalances like hypokalemia (3.1 mEq/L) caused by furosemide. There’s no indication of hypoxia in the lab results or scenario. This action doesn’t correct the potassium deficit or prevent further depletion, making it irrelevant and incorrect.
Choice C reason: Furosemide exacerbates hypokalemia (patient’s potassium: 3.1 mEq/L), risking cardiac arrhythmias or muscle weakness. Holding the dose prevents further potassium loss, and notifying the physician allows for correction (e.g., potassium supplements) and reassessment of therapy, making this the safest and most appropriate action.
Choice D reason: A 24-hour urine collection assesses renal function or output but doesn’t address the immediate concern of hypokalemia (3.1 mEq/L) caused by furosemide. This test is irrelevant to correcting the electrolyte imbalance or preventing further depletion, making it an inappropriate action in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Jaundice indicates liver dysfunction, but ibuprofen rarely causes hepatotoxicity at standard doses. It’s more associated with gastrointestinal issues due to COX-1 inhibition, reducing protective prostaglandins in the stomach lining. While possible with overdose, jaundice is less common than gastrointestinal bleeding, making this choice less likely.
Choice B reason: Ibuprofen, an NSAID, inhibits COX-1, reducing gastric mucosal protection, which can lead to ulcers or gastrointestinal bleeding. Bloody emesis (hematemesis) indicates severe gastrointestinal damage, a well-documented adverse effect requiring immediate intervention, making this the correct choice for a severe ibuprofen-related complication.
Choice C reason: Itching may indicate a mild allergic reaction or skin irritation, not a severe adverse effect of ibuprofen. While possible, it’s less critical than gastrointestinal bleeding, which poses life-threatening risks due to ibuprofen’s impact on gastric mucosa, making this choice less severe and incorrect.
Choice D reason: Dysmenorrhea (painful periods) is a condition ibuprofen treats, not an adverse effect. By inhibiting prostaglandins, ibuprofen reduces uterine contractions and pain. It doesn’t cause dysmenorrhea, making this choice irrelevant as an indicator of a severe adverse effect of ibuprofen therapy.
Correct Answer is D
Explanation
Choice A reason: To calculate the volume, divide the ordered dose (8 mg) by the concentration (5 mg/mL): 8 ÷ 5 = 1.6 mL. Choice A (1.4 mL) underestimates the volume, delivering only 7 mg (1.4 × 5), which is insufficient for the prescribed dose, making it incorrect for accurate medication administration.
Choice B reason: Calculating 8 mg ÷ 5 mg/mL yields 1.6 mL. Choice B (1.8 mL) would deliver 9 mg (1.8 × 5), exceeding the ordered dose. This overdose could increase the risk of sedation or respiratory depression, as Valium (diazepam) is a benzodiazepine with potent CNS effects, making this choice incorrect.
Choice C reason: The correct volume is 8 mg ÷ 5 mg/mL = 1.6 mL. Choice C (1.2 mL) delivers only 6 mg (1.2 × 5), which is below the prescribed dose. This underdose could result in inadequate therapeutic effects, such as insufficient anxiety relief or seizure control, making it an incorrect choice.
Choice D reason: Dividing the ordered dose (8 mg) by the concentration (5 mg/mL) gives 8 ÷ 5 = 1.6 mL. This volume accurately delivers the prescribed 8 mg of Valium, ensuring therapeutic efficacy for conditions like anxiety or seizures while minimizing risks of over- or under-dosing, making it the correct choice.
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