A nurse is assessing a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?

Weight gain

Distended neck veins

Shortness of breath

Elevated hematocrit level

Answer and Explanation

The Correct Answer is D

Choice A Reason:
Weight gain is incorrect. Weight gain is typically associated with fluid volume excess rather than deficit. In heart failure, fluid retention can lead to weight gain due to excess fluid accumulation in the body.
Choice B Reason:
Distended neck veins is incorrect. Distended neck veins are a sign of fluid volume excess, commonly seen in heart failure due to increased venous pressure and fluid retention.
Choice C Reason:
Shortness of breath is incorrect.: Shortness of breath is often associated with fluid accumulation in the lungs, known as pulmonary edema, which is a manifestation of fluid volume excess or fluid overload in heart failure.
Choice D Reason:
Elevated hematocrit level is correct. Furosemide is a diuretic that promotes diuresis (increased urine output), leading to fluid loss. When a client experiences fluid volume deficit or dehydration due to increased diuresis, there is a concentration of red blood cells in the blood, resulting in an elevated hematocrit level. This occurs because the blood becomes more concentrated when there's less fluid volume available.

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Correct Answer is A

Explanation

Choice A Reason:
Rotate the application site every week is correct. Rotating the application site is essential to prevent skin irritation or sensitization. Advising the client to apply the patch to a different area of clean, dry, non-hairy skin each time helps reduce the risk of skin irritation at the application site.
Choice B Reason:
The transdermal patch can cause insomnia is incorrect. Insomnia is a potential side effect of nicotine replacement therapy (NRT) patches, including transdermal nicotine patches, but it's not a universal side effect for everyone using the patch.
Choice C Reason:
Leave the patch in place for 8 hr. each day is incorrect. Transdermal nicotine patches are typically worn for 16–24 hours each day, depending on the specific product instructions. Leaving the patch on for a shorter duration might reduce its effectiveness in supporting smoking cessation.
Choice D Reason:
The transdermal patch releases nicotine rapidly into the bloodstream is incorrect. Transdermal nicotine patches deliver nicotine slowly through the skin into the bloodstream over an extended period rather than providing a rapid release. This gradual release helps reduce cravings and withdrawal symptoms associated with smoking cessation.

A. Ondansetron B. Acetaminophen C. Nalbuphine D. Insulin glargine

Correct Answer is C

Explanation

Choice A Reason:
Ondansetron is incorrect. Ondansetron is an anti-nausea medication commonly used in cancer patients to manage nausea and vomiting, often caused by chemotherapy. It's not typically contraindicated or known to interact significantly with morphine administered via a PCA pump. This combination is often used to manage both pain and associated symptoms in cancer patients.
Choice B Reason:
Acetaminophen is incorrect. Acetaminophen is a pain reliever and fever reducer that doesn't typically interact significantly with morphine administered via a PCA pump. It's often used concurrently with other pain medications to manage discomfort in cancer patients. There isn't a known significant interaction between acetaminophen and morphine when used appropriately.
Choice C Reason:
Nalbuphine is correct. Nalbuphine is an opioid analgesic, similar to morphine, and administering it concurrently with morphine could potentially lead to opioid overdose or increased risk of opioid-related side effects such as respiratory depression. Thus, it's crucial to clarify with the provider whether there might be a potential interaction or if both medications are indeed necessary in this specific clinical scenario.
Choice D Reason:
Insulin glargine is incorrect. Insulin glargine is a long-acting insulin used to manage blood sugar levels in individuals with diabetes. While its interaction with morphine isn't typically a concern, it's essential to monitor blood sugar levels closely in individuals receiving opioids like morphine, as opioids can affect glucose metabolism and may necessitate adjustments in insulin dosage.

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A nurse is assessing a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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