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. Ventricular tachycardia presents with wide QRS complexes and a fast ventricular rate, but not sawtooth P waves.
B. Atrial flutter is characterized by a rapid atrial rate (typically around 250–350 beats/min) and "sawtooth" flutter waves on the ECG. The ventricular response is often regular, as seen in this client with a ventricular rate of 82 beats/min.
C. Atrial fibrillation presents with an irregularly irregular rhythm and absent P waves, replaced by fibrillatory waves — not the sawtooth pattern described here.
D. Ventricular fibrillation shows chaotic, irregular, and disorganized electrical activity with no identifiable P waves, QRS complexes, or T waves, and would not present as a stable rhythm with a ventricular rate of 82 bpm.

A. To convert atrial fibrillation to sinus rhythm B. To slow the response of the ventricles to the fast atrial impulses C. To dissolve clots in the bloodstream D. To reduce the risk of stroke in clients who have atrial fibrillation

Correct Answer is D

Explanation

A. Warfarin does not convert atrial fibrillation to sinus rhythm; it is an anticoagulant, not a rhythm control medication.
B. Slowing ventricular response is achieved with rate-control medications like beta blockers or calcium channel blockers, not warfarin.
C. Warfarin prevents clot formation but does not dissolve existing clots.
D. Warfarin reduces the risk of stroke by preventing thrombus formation in clients with atrial fibrillation

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Naxlex Comprehensive Predictor Exams

The nurse is monitoring a client in the post-anesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm?

Correct Answer is B

Explanation

A nurse is preparing to administer warfarin to a client who has atrial fibrillation. The nurse should explain that the purpose of this medication is which of the following?

Correct Answer is D

Explanation

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