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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: A sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). While furosemide can cause hyponatremia, this value is not concerning. Hypokalemia is a greater risk with furosemide and digoxin, as it potentiates digoxin toxicity, making this choice less critical than potassium.

Choice B reason: Oxygen saturation of 95% is normal (95-100%). Crackles suggest pulmonary edema, but this saturation doesn’t indicate severe hypoxia requiring immediate action. Hypokalemia poses a greater risk with digoxin and furosemide, as it increases toxicity potential, making this choice less concerning.

Choice C reason: A potassium level of 3.0 mEq/L (normal: 3.5-5.0 mEq/L) indicates hypokalemia, exacerbated by furosemide’s diuretic effect. In digoxin use, low potassium increases cardiac toxicity risk, causing arrhythmias, especially with an irregular heart rate noted, making this the most concerning value requiring immediate attention.

Choice D reason: A blood glucose level of 100 mg/dL is normal (70-110 mg/dL fasting). It’s unrelated to digoxin or furosemide’s primary risks (e.g., electrolyte imbalances, arrhythmias). Hypokalemia is a more immediate concern due to its synergistic toxicity with digoxin, making this choice less critical.

A. Zithromax can cause cancer in women. B. Your medical conditions, age, and gender make you susceptible to QT prolongation, a known risk of this antibiotic. C. This antibiotic is less effective in women. D. Zithromax is expensive, so your insurance won’t pay for it.

Correct Answer is B

Explanation

Choice A reason is that Zithromax (azithromycin) is not linked to cancer in women; this is inaccurate. QT prolongation is a known risk, especially in elderly patients with cardiac issues, so this is incorrect.

Choice B reason: Azithromycin can prolong the QT interval, risking arrhythmias, particularly in older women with heart rhythm issues. This explains the different prescribing, making it the correct choice.

Choice C reason: Zithromax’s effectiveness is not gender-specific; efficacy depends on the infection, not sex. The cardiac risk is the concern, so this is incorrect for the explanation.

Choice D reason: Cost or insurance is irrelevant to the medical decision. QT prolongation risk in this patient’s profile drives the choice, so this is incorrect.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A female patient is questioning the nurse on why she can’t explain the same 5-day antibiotic (Zithromax) that her husband received. The patient is 65 with a history of and has an abnormal heart rhythm. The nurse explains that:

Correct Answer is B

Explanation

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