A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Cardiogenic shock

Left ventricular failure

Hypotension

Hypovolemia

Answer and Explanation

The Correct Answer is B

Choice A reason: Cardiogenic shock involves reduced cardiac output, typically with low PAWP due to decreased preload from poor heart function. Elevated PAWP reflects left atrial pressure buildup, not characteristic of cardiogenic shock alone, which is distinct from heart failure, requiring specific hemodynamic management.
Choice B reason: Elevated PAWP indicates left ventricular failure, where the heart cannot pump blood effectively, causing pulmonary congestion. This increases left atrial pressure, leading to pulmonary edema, a hallmark of heart failure. Diuretics and inotropes are needed to reduce fluid overload and improve cardiac function.
Choice C reason: Hypotension is a symptom, not a direct complication of elevated PAWP. It may occur in heart failure due to reduced cardiac output, but elevated PAWP specifically signals left heart dysfunction, not hypotension itself, which is a systemic response rather than a primary cardiac issue.
Choice D reason: Hypovolemia reduces blood volume, lowering PAWP due to decreased preload. Elevated PAWP suggests fluid overload or left ventricular dysfunction, not hypovolemia, which presents with low central venous pressure and dehydration signs, requiring fluid resuscitation rather than management of heart failure.

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Correct Answer is D

Explanation

Choice A reason: Bilirubin assesses liver function, not kidneys. Cyclosporine’s nephrotoxicity affects glomerular filtration, not heme metabolism. Monitoring bilirubin is irrelevant for renal function in transplant clients, as it reflects hepatic or hemolytic processes, not kidney health or drug toxicity.
Choice B reason: Alkaline phosphatase evaluates liver or bone health, not kidneys. Cyclosporine may cause hepatotoxicity, but renal monitoring is critical due to its nephrotoxic potential. Alkaline phosphatase does not reflect glomerular or tubular function, making it unsuitable for assessing renal impact.
Choice C reason: Amylase measures pancreatic function, not kidneys. Cyclosporine’s nephrotoxicity affects renal filtration, not pancreatic enzymes. Monitoring amylase is irrelevant for kidney transplant clients, as it does not indicate renal impairment or cyclosporine’s toxic effects on kidney function.
Choice D reason: Creatinine is a key renal function marker, reflecting glomerular filtration rate. Cyclosporine’s nephrotoxicity elevates creatinine, indicating kidney damage. Monitoring it with BUN ensures early detection of renal impairment, guiding dose adjustments to prevent further injury in transplant clients.

A. Administer calcium gluconate IV. B. Position the client supine. C. Prepare an IV bolus of dextrose. D. Administer methylergonovine IM.

Correct Answer is A

Explanation

Choice A reason: Calcium gluconate IV reverses magnesium sulfate toxicity, which causes respiratory depression or arrhythmias due to excessive magnesium. Calcium restores neuromuscular and cardiac function by competing with magnesium, preventing life-threatening complications like respiratory arrest in preeclampsia management.
Choice B reason: Positioning supine is inappropriate, as it does not address magnesium toxicity and may worsen respiration in preeclampsia. Semi-Fowler’s position optimizes breathing, while toxicity requires pharmacological reversal with calcium gluconate, not positional changes, to manage life-threatening symptoms effectively.
Choice C reason: IV dextrose is irrelevant for magnesium toxicity, which affects neuromuscular function, not glucose levels. Dextrose treats hypoglycemia, not applicable here. Magnesium overdose requires calcium to counteract effects, making dextrose an ineffective intervention in preeclampsia-related toxicity management.
Choice D reason: Methylergonovine, a uterotonic, is contraindicated in preeclampsia, as it increases blood pressure, risking hypertensive crisis. It treats postpartum hemorrhage, not magnesium toxicity, which requires calcium gluconate to reverse neuromuscular depression, ensuring safety in preeclampsia management.

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A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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