A 65-year-old patient with congestive heart failure has been on diuretic therapy for the past two weeks. During a follow-up appointment, which of the following findings would indicate that the diuretic therapy is effective?
Increase in blood pressure and heart rate
Significant weight gain over the past two weeks
Reduction in peripheral edema and improved breathing
Development of muscle cramps and weakness
The Correct Answer is C
Rationale:
A. This would indicate possible fluid retention or worsening heart function, not effective diuretic therapy. Effective diuretics usually help reduce fluid overload, which may lower blood pressure in hypertensive patients.
B. Rapid weight gain is a sign of fluid retention, which suggests diuretic therapy is not effective or the patient’s heart failure is worsening.
C. These findings indicate that excess fluid is being successfully removed from the body. Decreased swelling in the extremities and improved respiratory status reflect effective diuresis and improved cardiac function, which is the goal of therapy.
D. While these can occur due to electrolyte imbalances caused by diuretics, they are adverse effects rather than indicators of effectiveness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Although at the upper limit of normal (10–20 mg/dL), BUN alone is not a definitive indicator of AKI. It can be temporarily elevated due to dehydration, high-protein intake, or catabolic states, and must be interpreted alongside creatinine and other clinical findings.
B. This value is within the normal adult range (1.5–2.5 mEq/L). Magnesium levels generally remain stable until more significant kidney dysfunction occurs, so this does not indicate increased AKI risk.
C. This is within the normal range (3.5–5.0 mEq/L). While potassium imbalances can develop in AKI due to impaired excretion, a normal value does not reflect kidney injury.
D. This is elevated above the normal range for adult females (0.6–1.3 mg/dL) and reflects impaired kidney function. After a myocardial infarction, decreased cardiac output can reduce renal perfusion, placing the client at high risk for acute kidney injury. An elevated creatinine in this context warrants close monitoring, potential adjustments to medications, and prompt interventions to prevent further renal damage.
Correct Answer is ["B","C","E"]
Explanation
Rationale:
A. Orthopnea (difficulty breathing when lying flat) is more characteristic of heart failure, not the acute presentation of MI.
B. Chest pain is the hallmark symptom of an acute MI, often described as pressure, squeezing, or heaviness in the chest.
C. The sympathetic nervous system often responds to myocardial ischemia with increased heart rate, making tachycardia a common finding.
D. Headache is not a typical manifestation of MI and is not used in diagnostic assessment for acute coronary events.
E. Excessive sweating is a common autonomic response during an acute MI due to sympathetic activation and pain.
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