A client with a history of heart failure is prescribed furosemide. Which assessment finding indicates the medication is effective?

Increased urine output

Elevated blood pressure

Increased heart rate

Weight gain

Answer and Explanation

The Correct Answer is A

Choice A reason: Furosemide, a loop diuretic, promotes urine output by inhibiting sodium reabsorption in the kidneys, reducing fluid overload in heart failure. Increased urine output indicates effective diuresis, alleviating pulmonary and peripheral edema, making it the primary sign of therapeutic efficacy.

Choice B reason: Elevated blood pressure is not an expected effect of furosemide, which reduces preload and blood volume, often lowering pressure. Effective diuresis is shown by increased urine output, as this directly reflects fluid removal, critical for heart failure management.

Choice C reason: Increased heart rate is not a direct indicator of furosemide efficacy. Diuresis reduces cardiac workload, potentially stabilizing heart rate, but urine output is the primary measure, as it confirms fluid excretion, the medication’s main action in heart failure.

Choice D reason: Weight gain indicates fluid retention, the opposite of furosemide’s goal. Effective diuresis causes weight loss due to fluid excretion. Increased urine output is the key sign, as it directly measures the diuretic’s action in reducing heart failure-related fluid overload.

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Correct Answer is B

Explanation

Choice A reason: Difficulty with urination is not a primary concern for pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis to enhance neuromuscular transmission. While cholinergic side effects may include urinary urgency, this is not a pre-administration priority compared to oral intake, which affects absorption and efficacy.

Choice B reason: Recent oral intake is critical before administering pyridostigmine, as food can delay its absorption, reducing effectiveness in myasthenia gravis. Taking it 30–60 minutes before or 2 hours after meals ensures optimal plasma levels, improving muscle strength, making this the priority information to obtain.

Choice C reason: Trouble sleeping is not directly relevant to pyridostigmine administration. While cholinergic side effects like diarrhea may disrupt sleep, this is a secondary concern. Ensuring proper timing with oral intake is critical for therapeutic efficacy, as absorption impacts symptom control in myasthenia gravis.

Choice D reason: Unexplained weight loss may indicate myasthenia gravis progression or other issues but is not a pre-administration concern for pyridostigmine. Timing with oral intake directly affects the drug’s pharmacokinetics, ensuring effective muscle strength improvement, making weight loss less urgent to assess before dosing.

A. Obtain an arterial blood gas prior to the procedure B. Perform the drainage immediately after meals C. Instruct the client to breathe shallow and fast D. Explain that the client may be placed in five positions

Correct Answer is D

Explanation

Choice A reason: Obtaining an arterial blood gas assesses oxygenation and acid-base status, useful in COPD management, but is not required before postural drainage. This invasive procedure is unnecessary for routine drainage, which mobilizes secretions. Explaining positions prepares the client, enhancing cooperation and effectiveness.

Choice B reason: Performing drainage after meals risks aspiration or vomiting, as a full stomach increases intra-abdominal pressure in COPD patients. Postural drainage is most effective when performed on an empty stomach, making this approach incorrect. Patient education on positioning is the priority.

Choice C reason: Shallow, fast breathing is counterproductive in COPD, as it reduces tidal volume and worsens hypercapnia. Postural drainage requires slow, deep breaths to mobilize secretions and improve ventilation. Explaining positions ensures proper technique, making this breathing instruction incorrect.

Choice D reason: Explaining that the client may be placed in five positions (e.g., prone, supine, lateral) prepares them for postural drainage, which uses gravity to mobilize lung secretions in COPD. This education enhances compliance and effectiveness, as proper positioning is critical for therapeutic success, making it the correct approach.

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A client with a history of heart failure is prescribed furosemide. Which assessment finding indicates the medication is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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