A client with a history of heart failure presents with progressive shortness of breath over the last several days. Upon assessment, the nurse notes jugular venous distention, crackles in the lung bases auscultated bilaterally, and a bounding pulse. Which of the following interventions would be the nurse's priority?

Administration of IV antibiotics

Administration of IV diuretics

Isotonic intravenous fluids

Lay the client supine with legs elevated

Answer and Explanation

The Correct Answer is B

A. Administration of IV antibiotics is not appropriate for this client, as there is no indication of an infection. The client's symptoms are consistent with fluid overload due to heart failure, not an infectious process.
B. Administration of IV diuretics is the priority intervention. The client is exhibiting signs of fluid overload, including jugular venous distention, crackles, and a bounding pulse. IV diuretics, such as furosemide, help reduce fluid volume, alleviate pulmonary congestion, and improve breathing.
C. Isotonic intravenous fluids would exacerbate the fluid overload and worsen the client's symptoms. This intervention is contraindicated in this scenario.
D. Laying the client supine with legs elevated is inappropriate for a client with heart failure and fluid overload, as it can increase venous return to the heart and worsen pulmonary congestion. Instead, the client should be positioned upright to improve breathing.

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Correct Answer is D

Explanation

A. Encouraging the client to void every 5-6 hours is not appropriate for preventing complications in chronic pyelonephritis. Regular voiding every 2-3 hours is recommended to prevent urinary stasis and bacterial growth.
B. Limiting fluid intake to 1.5L/day is counterproductive in chronic pyelonephritis, as it increases the risk of concentrated urine and urinary tract infections.
C. While decreasing sodium intake may be beneficial in other conditions, it is not directly relevant to managing chronic pyelonephritis. The focus is on maintaining adequate hydration.
D. Increasing fluid intake to at least 3 L/day helps dilute the urine, reduce bacterial concentration, and flush out the urinary system, which is essential for managing and preventing further episodes of pyelonephritis.

A. Inverted P wave B. Wide QRS C. Elevated ST segment D. Flattened T wave

Correct Answer is D

Explanation

A. An inverted P wave is not typically associated with hypokalemia but may indicate other conduction abnormalities such as atrial ectopic rhythms.
B. A wide QRS complex is more commonly associated with hyperkalemia rather than hypokalemia. It may also indicate other conduction delays or ventricular issues.
C. An elevated ST segment suggests myocardial injury or pericarditis, not hypokalemia.
D. A flattened T wave is a hallmark of hypokalemia. Low potassium levels affect the repolarization phase of the cardiac cycle, leading to T wave flattening or inversion and, in severe cases, the presence of a U wave.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing education to a patient with chronic pyelonephritis about health promotion activities. Which of the following actions should the nurse include in the teaching?

Correct Answer is D

Explanation

A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?

Correct Answer is D

Explanation

A patient presents with a heart rate of 130 beats/minute and a blood pressure of 82/66 after exerting themselves in the sun. Which of the following interventions would be most appropriate?

A nurse is providing education to a client newly prescribed Sulfasalazine and Azathioprine for refractory ulcerative colitis. Which of the following statements by the client indicates that further teaching is required?

A nurse is planning care for a client who has dehydration and is receiving a continuous IV infusion of 0.9% sodium chloride. Which of the following interventions should the nurse include in the plan of care?

The nurse is caring for a client who was admitted for an acute exacerbation of Crohn's Disease with severe diarrhea for the last two days. The nurse knows that which of the following is the priority risk for this client?

The nurse is planning care for a client with type 1 diabetes mellitus. When planning administration for rapid-acting insulin Lispro, the nurse knows to administer it during which timeframe based on the onset of action?

Which of the following signs and symptoms from a client who came to the clinic for an exacerbation of Crohn's Disease is the most concerning?

The nurse is providing education to a client newly diagnosed with gastroesophageal reflux disease (GERD). The nurse knows that the teaching was effective when the client states they should eat which of the following foods?