The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Carvedilol

Captopril

Isosorbide dinitrate

Fluticasone

Answer and Explanation

The Correct Answer is A

A. Carvedilol: Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.

B. Captopril: Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.

C. Isosorbide dinitrate: Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.

D. Fluticasone: Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.

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Correct Answer is C

Explanation

Correct answer: C

A. Bumetanide 1 mg IV bolus every 12 hr is a loop diuretic used to help reduce fluid overload and manage heart failure symptoms. This medication helps remove excess fluid from the body and can be beneficial for a client with acute heart failure following an MI.

B. Laboratory testing of serum potassium upon admission: It is common to monitor serum potassium levels in patients receiving diuretics, especially loop diuretics, to prevent electrolyte imbalances.

C.Administering 0.9% normal saline IV at a continuous rate can potentially exacerbate heart failure by increasing fluid volume, leading to fluid overload and worsening symptoms. In acute heart failure, fluid management is critical, and fluids are typically restricted to prevent further strain on the heart.

D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain: Morphine sulfate is prescribed for pain management and is commonly used in acute heart failure situations to relieve anxiety and decrease preload on the heart. The dosing frequency is appropriate as "every 2 hr PRN" indicates it should be administered as needed for pain relief.

A. Dependent edema B. Jugular distention C. Nocturnal polyuria D. Frothy sputum

Correct Answer is D

Explanation

A. Dependent edema: Dependent edema is more commonly associated with right-sided heart failure. In left-sided heart failure, fluid accumulates in the lungs, leading to pulmonary symptoms such as cough and frothy sputum.
B. Jugular distention: Jugular distention is often associated with right-sided heart failure due to impaired blood flow from the right atrium into the right ventricle. It is less likely to be prominent in left-sided heart failure.
C. Nocturnal polyuria: Nocturnal polyuria (increased urination at night) is a common symptom of heart failure, but it is not specific to left-sided heart failure. It can be seen in both left- and right-sided heart failure.
D. Frothy sputum: This is the correct answer. Left-sided heart failure can lead to pulmonary congestion, resulting in the accumulation of fluid in the lungs. Frothy, pink-tinged sputum is a characteristic finding in left-sided heart failure and is often associated with pulmonary edema.

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The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

Correct Answer is C

Explanation

A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect?

Correct Answer is D

Explanation

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