A nurse is assessing a client with congestive heart failure. Which finding indicates possible fluid accumulation in the lungs, a common symptom of CHF?
Wheezing on auscultation
Hyperactive bowel sounds
Absence of jugular vein distention
Crackles on auscultation
The Correct Answer is D
A) This choice is incorrect because wheezing on auscultation is a characteristic finding in respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD), not congestive heart failure.
B) This choice is incorrect because hyperactive bowel sounds are not specific to congestive heart failure and are more indicative of gastrointestinal activity.
C) This choice is incorrect because the absence of jugular vein distention is not directly related to fluid accumulation in the lungs. Jugular vein distention is associated with right-sided heart failure.
D) This choice is correct. Crackles, also known as rales, are abnormal lung sounds heard on auscultation and may indicate fluid accumulation in the lungs, a common symptom of congestive heart failure. The presence of crackles suggests pulmonary congestion due to fluid leaking into the alveoli.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) This choice is incorrect because loop diuretics can lead to increased sodium excretion, potentially causing hypernatremia (high sodium levels) rather than hyponatremia (low sodium levels).
B) This choice is incorrect because loop diuretics do not typically cause hypocalcemia (low calcium levels). They primarily affect sodium, potassium, and water excretion.
C) This choice is incorrect because loop diuretics are more likely to cause hypokalemia (low potassium levels) rather than hyperkalemia (high potassium levels). Loop diuretics can increase potassium excretion, leading to a potential deficiency.
D) This choice is correct. Loop diuretics are potent potassium-wasting diuretics, meaning they increase potassium excretion in the urine, potentially causing hypokalemia. The nurse should closely monitor the client's potassium levels and provide potassium supplementation if necessary.
Correct Answer is C
Explanation
A) This choice is incorrect because serum sodium levels are not directly impacted by digoxin. However, electrolyte imbalances, including hypokalemia, can potentiate digoxin toxicity, so potassium levels should be monitored.
B) This choice is incorrect because while digoxin can impact liver function, it is not the primary parameter to be monitored. Liver function tests may be performed periodically to assess liver health during digoxin therapy.
C) This choice is correct. Digoxin is a cardiac glycoside that can impact renal function. Monitoring urine output is essential to assess kidney function and the client's response to the medication.
D) This choice is incorrect because blood glucose levels are not specifically impacted by digoxin. However, hypokalemia resulting from digoxin therapy can cause alterations in glucose metabolism, so blood glucose levels should be monitored in clients taking digoxin.
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.
