A client with a history of emphysema and heart failure is admitted to the emergency department with enema, coughing, and shortness of breath. The client's laboratory value for brain natriuretic peptide is elevated. Which prescription is most important for the nurse to implement?

Administer IV furosemide.

Insert an indwelling urinary catheter.

Monitor for telemetry ST segment changes.

Give a bronchodilator per inhaler.

Answer and Explanation

The Correct Answer is A

Choice A reason: Administering IV furosemide (a diuretic) is crucial for managing the client's symptoms of fluid overload, as indicated by enema and elevated brain natriuretic peptide (BNP) levels. Furosemide helps reduce the volume of fluid in the body, relieving symptoms of heart failure and improving breathing. It addresses the most urgent need for the client.

Choice B reason: Inserting an indwelling urinary catheter might be necessary for accurate measurement of urine output, especially in a client receiving diuretic therapy. However, it is not the most immediate intervention needed to stabilize the client's condition.

Choice C reason: Monitoring for telemetry ST segment changes is important for clients with cardiac conditions. While it is necessary for ongoing assessment, it does not address the immediate need to relieve fluid overload and improve the client's respiratory status.

Choice D reason: Giving a bronchodilator per inhaler can help with respiratory symptoms related to emphysema. However, in this scenario, the primary issue is fluid overload due to heart failure, which needs to be addressed first with diuretic therapy.

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Correct Answer is D

Explanation

Choice A reason: Lethargy and lack of appetite are symptoms that might indicate hypothyroidism or an insufficient dosage of levothyroxine. These symptoms are not typically associated with a dosage that is too high.

Choice B reason: Bradycardia and constipation are also indicative of hypothyroidism or an inadequate dosage of levothyroxine. These symptoms suggest a need for a higher dosage rather than indicating that the current dosage is too high.

Choice C reason: Muscle cramping and dry, flushed skin can be associated with electrolyte imbalances or dehydration, but they are not specific symptoms of an excessive dosage of levothyroxine.

Choice D reason: Palpitations and shortness of breath are signs of hyperthyroidism, which can occur if the dosage of levothyroxine is too high. These symptoms indicate that the client's metabolism is excessively stimulated, leading to cardiovascular strain and respiratory distress. It is crucial for the nurse to monitor these symptoms and adjust the medication dosage accordingly.

A. "I will wash my hands with warm soapy water before sticking my finger." B. "I will use a lancing device on the centre of my finger pad for a drop of blood." C. "I will inform the healthcare provider of my average haemoglobin A1C results weekly." D. "I will document my haemoglobin A1C results from the SMBG monitor every morning."

Correct Answer is A

Explanation

Choice A reason: Washing hands with warm soapy water before sticking the finger is a critical step in the process of self-monitoring blood glucose. Clean hands help prevent infections and ensure that the blood sample is not contaminated, which can affect the accuracy of glucose readings. This practice indicates that the client understands and can effectively follow the proper procedure for SMBG.

Choice B reason: Using a lancing device on the centre of the finger pad is not the correct technique. The sides of the finger pads are recommended for pricking because they are less sensitive than the centre and can provide a better sample with less discomfort. This indicates a misunderstanding of the correct procedure.

Choice C reason: Informing the healthcare provider of average haemoglobin A1C results weekly is unnecessary. Haemoglobin A1C is typically measured every 3 to 6 months to monitor long-term glucose control. Weekly reporting is not required and shows a lack of understanding about the appropriate use of A1C measurements.

Choice D reason: Documenting haemoglobin A1C results from the SMBG monitor every morning is incorrect. The SMBG monitor measures daily blood glucose levels, not haemoglobin A1C. Haemoglobin A1C provides an average blood glucose level over the past 2 to 3 months and is not obtained from daily SMBG readings.

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A client with a history of emphysema and heart failure is admitted to the emergency department with enema, coughing, and shortness of breath. The client's laboratory value for brain natriuretic peptide is elevated. Which prescription is most important for the nurse to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 26-year-old client is admitted to the hospital for treatment of a simple goitre, and levothyroxine sodium is prescribed. Which symptoms indicate to the nurse that the prescribed dosage is too high for this client?

Correct Answer is D

Explanation

A client is newly diagnosed with type 2 diabetes mellitus. The nurse is educating the client about self-monitoring blood glucose (SMBG) and haemoglobin A1C. Which statement by the client indicates teaching has been effective?

Correct Answer is A

Explanation

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