A nurse is admitting a client who has acute heart failure. Which of the following prescriptions from the provider should the nurse anticipate?
Provide the client with a 4g sodium diet.
Ambulate the client every 4 hr while awake.
Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr.
Administer enalapril 2.5 mg PO twice daily.
The Correct Answer is D
A) Provide the client with a 4g sodium diet: This is incorrect. Clients with acute heart failure typically require a low-sodium diet (often less than 2g per day) to help manage fluid retention and reduce workload on the heart.
B) Ambulate the client every 4 hr while awake: While mobility is important, the frequency and timing of ambulation in clients with acute heart failure should be carefully considered based on their stability and fatigue level. It may not be appropriate to ambulate every 4 hours.
C) Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr: This is generally not appropriate for clients with acute heart failure due to the risk of fluid overload. Instead, fluid management often involves restricting IV fluids and closely monitoring fluid balance.
D) Administer enalapril 2.5 mg PO twice daily: This prescription is appropriate. Enalapril, an ACE inhibitor, is commonly used to manage heart failure by reducing afterload and improving cardiac output. It helps alleviate symptoms and improve quality of life in heart failure patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) "I should use a soft-bristle toothbrush to clean my teeth after meals.": Using a soft-bristle toothbrush is crucial for clients with stomatitis, as it minimizes irritation to sensitive oral tissues. Gentle oral hygiene practices help maintain oral health and reduce discomfort, indicating that the client understands the need for careful dental care during radiation therapy.
B) "I should limit my intake of dairy products to prevent nausea.": While some clients may experience nausea, limiting dairy is not typically recommended for managing stomatitis. In fact, dairy can be soothing for some individuals. This statement does not address the specific needs related to stomatitis and indicates a misunderstanding of dietary management during treatment.
C) "I should gargle with an alcohol-based mouthwash to kill germs.": Alcohol-based mouthwashes can further irritate the mucous membranes and exacerbate stomatitis symptoms. Acknowledging this would demonstrate a lack of understanding, as alcohol is contraindicated in the management of oral mucosal irritation caused by radiation therapy.
D) "I should moisten my lips with lemon-glycerin swabs.": Lemon-glycerin swabs can actually irritate the mouth and exacerbate discomfort in clients with stomatitis. This approach is not recommended, and selecting such a treatment indicates a misunderstanding of appropriate oral care measures during radiation therapy.
Correct Answer is B
Explanation
A) Flattening of the artificial airway cuff: This may indicate issues with the cuff pressure or an air leak but does not directly reflect the effectiveness of suctioning.
B) Decreased peak inspiratory pressure: This is the correct answer. A decrease in peak inspiratory pressure suggests that the airway is clearer, allowing for better airflow and indicating that the suctioning was effective in removing secretions that may have caused airway obstruction.
C) Presence of a productive cough: While this can indicate the expulsion of secretions, it may not be a reliable measure of the effectiveness of suctioning in a mechanically ventilated patient, as they may not be able to cough effectively.
D) Thinning of mucous secretions: While thinning secretions can be beneficial, it does not directly indicate that the suctioning itself was effective. The focus should be on airflow and pressure changes.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.