A nurse is caring for a client who has hypovolemic shock. Which of the following should the nurse recognize as an expected finding?

Hypertension

Bradypnea

Oliguria

Flushing of the skin

Answer and Explanation

The Correct Answer is C

Choice A Reason: This is incorrect because hypertension is a condition of high blood pressure. A client who has hypovolemic shock is more likely to have hypotension, which is a condition of low blood pressure, due to ﬂuid loss and reduced cardiac output.

Choice B Reason: This is incorrect because bradypnea is a condition of slow breathing. A client who has hypovolemic shock is more likely to have tachypnea, which is a condition of fast breathing, due to hypoxia and increased respiratory demand.

Choice C Reason: This is correct because oliguria is a condition of low urine output. A client who has hypovolemic shock may have oliguria due to decreased renal perfusion and activation of the renin-angiotensin-aldosterone system, which causes sodium and water retention.

Choice D reason: This is incorrect because ﬂushing of the skin is a condition of redness and warmth of the skin. A client who has hypovolemic shock may have pallor and coolness of the skin due to vasoconstriction and reduced blood ﬂow.

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Correct Answer is B

Explanation

Choice A Reason: This choice is incorrect because furosemide is a diuretic that helps to reduce ﬂuid retention and edema. It may be used for clients who have heart failure or hypertension, but it does not treat pulmonary embolism.

Choice B Reason: This choice is correct because heparin is an anticoagulant that helps to prevent blood clots from forming or growing larger. It may be used for clients who have pulmonary embolism, which is a blockage of a pulmonary artery by a blood clot that usually originates from a deep vein thrombosis (DVT). Heparin can reduce the risk of complications such as pulmonary infarction or death.

Choice C Reason: This choice is incorrect because dexamethasone is a corticosteroid that helps to reduce inﬂammation and immune response. It may be used for clients who have allergic reactions, asthma, or autoimmune diseases, but it does not treat pulmonary embolism.

Choice D Reason: This choice is incorrect because epinephrine is a sympathomimetic that helps to stimulate the heart and blood vessels. It may be used for clients who have cardiac arrest, anaphylaxis, or severe asthma, but it does not treat pulmonary embolism.

Choice E Reason: This choice is incorrect because atropine is an anticholinergic that helps to block the eﬀects of acetylcholine on the heart and smooth muscles. It may be used for clients who have bradycardia, atrioventricular block, or organophosphate poisoning, but it does not treat pulmonary embolism.

A. Laboratory testing of serum potassium upon admission B. Bumetanide 1 mg IV bolus every 12 hr C. 0.9% normal saline IV at 50 mL/hr continuous D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain

Correct Answer is C

Explanation

Choice A Reason: This choice is incorrect because laboratory testing of serum potassium upon admission is an appropriate prescription for a client who has acute heart failure following MI. Serum potassium is an electrolyte that aﬀects the cardiac function and rhythm. A normal serum potassium range is 3.5 to 5 mEq/L, and an abnormal level can indicate hypokalemia or hyperkalemia, which can cause arrhythmias, muscle weakness, or paralysis. Therefore, monitoring serum potassium is important to detect and correct any electrolyte imbalance and prevent complications.

Choice B Reason: This choice is incorrect because bumetanide 1 mg IV bolus every 12 hr is an appropriate prescription for a client who has acute heart failure following MI. Bumetanide is a loop diuretic that helps to reduce ﬂuid retention and edema by increasing the urine output and sodium excretion. It may be used for clients who have heart failure, hypertension, or renal impairment, but it can cause hypokalemia, hypotension, or dehydration.

Therefore, administering bumetanide as prescribed can help to improve the cardiac output and reduce the preload and afterload.

Choice C Reason: This choice is correct because 0.9% normal saline IV at 50 mL/hr continuous is an inappropriate prescription for a client who has acute heart failure following MI. 0.9% normal saline is an isotonic solution that contains the same concentration of solutes as blood plasma. It may be used for clients who have ﬂuid loss, dehydration, or shock, but it can worsen ﬂuid overload and pulmonary edema in clients who have acute heart failure. Therefore, clarifying this prescription with the provider is necessary to prevent further deterioration of the client's condition.

Choice D Reason: This choice is incorrect because morphine sulfate 2 mg IV bolus every 2 hr PRN pain is an appropriate prescription for a client who has acute heart failure following MI. Morphine sulfate is an opioid analgesic that helps to relieve pain and anxiety by binding to the opioid receptors in the brain and spinal cord. It may be used for clients who have moderate to severe pain, dyspnea, or chest discomfort, but it can cause respiratory depression, hypotension, or nausea. Therefore, administering morphine sulfate as prescribed can help to reduce the oxygen demand and improve the cardiac function.

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A nurse is caring for a client who has hypovolemic shock. Which of the following should the nurse recognize as an expected finding?

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