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 D

Explanation

A. Scarring of the mitral valve is typically associated with rheumatic heart disease, not pericarditis.
B. Deformity of the valve leaflets is seen in valvular heart diseases, not pericarditis.
C. Inflammation of the endocardium refers to endocarditis, a different condition from pericarditis.
D. Pericardial effusion, the accumulation of fluid in the pericardial sac, is a common complication of pericarditis and can lead to cardiac tamponade if not managed.

A. Sick sinus syndrome B. Normal sinus rhythm C. Sinus bradycardia D. First degree heart block

Correct Answer is B

Explanation

A. Sick sinus syndrome – This involves an abnormal SA node function, often with varying rhythm disturbances (e.g., sinus pauses, bradycardia-tachycardia). The strip described is regular and does not reflect these changes.
B. Normal sinus rhythm – The rhythm is regular, the PR interval is within normal limits (0.12–0.20 seconds), the heart rate is 60 beats/min (within the normal range of 60–100), and P waves precede each QRS complex consistently.
C. Sinus bradycardia – Although the rate is 60, which is at the low end of normal, it is not below 60. Bradycardia is defined as <60 bpm.
D. First-degree heart block – First-degree AV block is characterized by a prolonged PR interval >0.20 seconds. The PR interval here is 0.16 seconds, which is normal.

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Naxlex Comprehensive Predictor Exams

The nurse providing discharge teaching to a client admitted with pericarditis. The nurse informs the client that pericarditis can lead to:

Correct Answer is D

Explanation

A nurse is assessing an ECG rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second. The overall heart rate is 60 beats/min. The nurse assesses the cardiac rhythm as:

Correct Answer is B

Explanation

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