A 74-year-old client with a history of heart failure is admitted to the coronary care unit with acute pulmonary edema. They are intubated and placed on a ventilator. Which of the following parameters should the nurse closely monitor in assessing the client's response to a bolus dose of IV furosemide (Lasix)?

Serum sodium levels

Daily weight

Hourly urine output

24-hour intake and output

Answer and Explanation

The Correct Answer is C

A. Serum sodium levels are important to monitor over time with diuretic therapy but do not provide immediate feedback on the effect of a bolus dose of furosemide.
B. Daily weight helps assess long-term fluid status but is not helpful for evaluating an acute response.
C. Hourly urine output is the most appropriate and immediate measure to assess the effectiveness of a bolus dose of IV furosemide, especially in a critically ill client with acute pulmonary edema.
D. 24-hour intake and output provides a broader picture but does not offer real-time assessment like hourly output does.

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Correct Answer is B

Explanation

A. A heart rate of 160/min is more indicative of the progressive stage of shock, where compensation begins to fail.
B. Blood pressure 115/68 mmHg is within normal limits and reflects the compensatory stage, where the body maintains perfusion through mechanisms like increased heart rate and vasoconstriction.
C. Hypokalemia is not a typical finding in the compensatory stage; electrolyte shifts are more pronounced in later stages.
D. Mottled skin is a sign of poor perfusion, typically seen in the progressive or irreversible stages of shock.

A. I B. II C. IV D. III

Correct Answer is D

Explanation

A. Class I: No limitation of physical activity; ordinary activity does not cause symptoms. This client clearly experiences symptoms with ordinary activities.
B. Class II: Slight limitation of physical activity; comfortable at rest, but ordinary activity causes fatigue, dyspnea, or chest pain. This client is more limited than Class II.
C. Class IV: Unable to carry out any physical activity without discomfort; symptoms may be present even at rest. This client does not have symptoms at rest.
D. Class III: Marked limitation of physical activity; comfortable at rest, but less-than-ordinary activity (e.g., brushing teeth, walking to the bathroom) causes fatigue, dyspnea, or chest pain. This best fits the client's condition.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is D

Explanation

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