A client was admitted to the intensive care unit after having an abdominal aortic aneurysm resection. The client's cardiac monitor shows a heart rate of 110. The clients hemodynamic monitoring shows a Central Venous Pressure (CVP): 1 mmHg and a Pulmonary Arterial Wedge Pressure (PAWP): 3 mmHg. Which health care provider order would the nurse anticipate receiving?

Monitor hemodynamic monitoring parameters again in one hour.

Administer Furosemide (Lasix) 20mg IVP.

Decrease IV Fluids to 75ml/hr and recheck hemodynamic parameters.

Administer 0.9% Normal Saline @ 150ml/hr

Answer and Explanation

The Correct Answer is D

A. Although monitoring hemodynamic parameters is important, this option does not address the immediate issue of low preload, as indicated by the low CVP and PAWP, suggesting hypovolemia.

B. Furosemide is a diuretic and would further decrease intravascular volume, which is inappropriate given the signs of hypovolemia.

C. Decreasing IV fluids would exacerbate the low preload and worsen the client's condition by reducing intravascular volume even further.

D. Administering 0.9% Normal Saline @ 150 mL/hr is the most appropriate intervention. The low CVP and PAWP indicate hypovolemia, and increasing fluid administration will help to increase the preload, thereby improving the client's hemodynamic status.

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Correct Answer is B

Explanation

A. Lantus insulin does not directly affect potassium levels in the same way that digoxin does.

B. A potassium level of 3.0 mEq/L is low, and digoxin toxicity can occur when potassium levels are low, leading to an increased risk of arrhythmias. This requires immediate attention to avoid serious complications.

C. Metoprolol is a beta-blocker that does not directly cause hypokalemia and is less of an immediate concern.

D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that could affect kidney function but does not directly impact potassium levels as significantly as digoxin.

A. 2+ bilateral peripheral edema B. Heart rate 59 beats/min C. Temperature of 96 F D. Muffled heart sounds

Correct Answer is D

Explanation

A. Bilateral peripheral edema can occur after heart catheterization but is not as immediately life-threatening as cardiac tamponade.

B. A heart rate of 59 beats/min may be concerning, but bradycardia alone is not as immediately urgent as signs of cardiac tamponade.

C. A temperature of 96°F is low, but this is more of a concern for hypothermia or post-procedural effects and is not as urgent as muffled heart sounds indicating tamponade.

D. Muffled heart sounds can indicate cardiac tamponade, a medical emergency. Immediate intervention is required to relieve the pressure on the heart, which may involve pericardiocentesis to drain the fluid or blood.

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Naxlex Comprehensive Predictor Exams

A client who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the client is on which medication?

Correct Answer is B

Explanation

The nurse is caring for a client after a heart catheterization. What complication must the nurse intervene for immediately?

Correct Answer is D

Explanation

The health care provider orders: Epinephrine 0.25 mg IV stat Pharmacy provides: Epinephrine 0.1 mg/mL. How many mL will the nurse prepare to administer? (Round to one decimal place.)

Which client should the nurse assign as a roommate for a client who has aplastic anemia?

Which assessment finding in a 36-year-old client is most indicative for further evaluation?

A 36-yr-old client who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?

A client who is on the progressive care unit develops atrial flutter, rate 150 with dyspnea, shortness of breath and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?