75-year-old who lives alone, is admitted to the hospital because of weakness and confusion.

Physical Examination

Confusion, slow to respond to questioning, generalized weakness, decreased skin turgor, dry mucous membranes, peripheral pulses weak.

Vitals: T: 101 F, BP 90/62, HR 120 bpm and irregular, RR 24, Sp02 89% on room air.

Central Venous Pressure (CVP): 1 mmHg

Pulmonary Arterial Wedge Pressure (PAWP): 2 mmHg.

Test Name

Results

Reference Range

WBC

12, 000

4, 000- 11, 000

Na+

149 mEq/L

135-145 mEq/L

K+

5.0 mEq/L

3.5- 5.0 mEq/L

Cl-

110 mEq/L

96-106 mEq/L

pH

7.34

7.35-7.45

PaCO2

34 mmHg

35- 45 mmHg

PaO2

78 mm Hg

80-100 mmHg

HCO3

21 mEq/L

22- 26 mEq/L

What order by the health care provider should the nurse question?

Increase 0.9% Normal Saline infusion to 250 ml/hr per protocol.

Collect blood cultures and start Vancomycin 1gm IV.

Collect UA for culture and sensitivity.

Administer Furosemide (Lasix) 20mg IV push.

Answer and Explanation

The Correct Answer is D

A. Increasing normal saline infusion is appropriate for treating dehydration and hypovolemia.

B. Collecting blood cultures and administering antibiotics is appropriate for treating possible sepsis, given the fever and elevated WBC count.

C. Collecting a urine sample for culture and sensitivity is appropriate to investigate a potential urinary source of infection.

D. Administering furosemide, a diuretic, is inappropriate in a client with signs of dehydration and hypovolemia (e.g., low CVP and PAWP) as it can worsen fluid depletion.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. The best response is to educate the client about the cause of Prinzmetal angina. It occurs due to spasm in the coronary arteries, which is different from the plaque buildup seen in traditional coronary artery disease. This response addresses the client's concern in an accurate and reassuring manner.

B. While healthy eating is important, Prinzmetal angina is not typically caused by cholesterol or plaque buildup. This response could increase the client's anxiety.

C. While acknowledging the client's emotions is important, this response does not address the underlying concern or provide an accurate explanation of Prinzmetal angina.

D. Offering reassurance without providing accurate information about the condition does not help the client understand the cause of their symptoms and could leave them confused or anxious.

A. Blood glucose of 182 mg/dL B. History of high cholesterol C. Elevated liver enzymes D. History of peptic ulcers

Correct Answer is C

Explanation

A. Blood glucose elevation is a concern for statins, but it is not a primary reason for questioning the order.

B. A history of high cholesterol is common and would not trigger concern regarding lovastatin.

C. Lovastatin can cause liver toxicity, so elevated liver enzymes are a contraindication or cause for concern when prescribing this medication. The nurse should verify this before starting the medication.

D. A history of peptic ulcers is unrelated to the use of lovastatin and would not be a concern in this case.

View Question and Answer

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Test Name	Results	Reference Range
WBC	12, 000	4, 000- 11, 000
Na+	149 mEq/L	135-145 mEq/L
K+	5.0 mEq/L	3.5- 5.0 mEq/L
Cl-	110 mEq/L	96-106 mEq/L
pH	7.34	7.35-7.45
PaCO2	34 mmHg	35- 45 mmHg
PaO2	78 mm Hg	80-100 mmHg
HCO3	21 mEq/L	22- 26 mEq/L

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

After reviewing the client's chart upon admission to the unit, the nurse consults the healthcare provider about a new order for lovastatin (Mevacor). What triggered the nurse's action?

Correct Answer is C

Explanation

The nurse is caring for a client who has frequent gastric pain and dyspepsia. Which procedure would the nurse expect the health care provider to order to make an accurate diagnosis?

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