A nurse is collecting data from a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the medication is eﬀective?

Decreased hemoglobin level

Increased urinary output

Decreased BUN level

Increased weight of 0.91 kg (2 lb)

Answer and Explanation

The Correct Answer is B

Furosemide is a diuretic medication that helps remove excess ﬂuid from the body by increasing urine production and output. In a client with heart failure, one of the indicators that the medication is eﬀective is an increase in urinary output. This can help reduce ﬂuid buildup in the body, which can improve symptoms of heart failure.

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Correct Answer is B

Explanation

This response acknowledges the client's experience and shows a willingness to understand and address their concerns.

It opens up a dialogue about the hallucinations, allowing the nurse to gather more information and assess the client's current mental state. It also demonstrates empathy and support, which can help build trust between the nurse and the client.

Offering to discuss the voices with the client can also help in developing coping strategies and exploring potential interventions to manage the hallucinations effectively.

A. Maintain low-level lights in common areas. B. Give the client several meal options at lunchtime. C. Confront the client regarding inappropriate behavior. D. Use symbols in the communal room signage.

Correct Answer is D

Explanation

A.Maintain low-level lights in common areas.Inadequate lighting can contribute to disorientation and falls. Well-lit areas with natural or soft lighting are preferable.

B.Give the client several meal options at lunchtime.Too many choices can be overwhelming and increase confusion. Instead, limiting choices (e.g., offering just two meal options) is a better approach.

C.Confront the client regarding inappropriate behavior.Confrontation can increase agitation and distress. Instead, redirection and gentle guidance are more effective strategies.

D. Use symbols in the communal room signage.Clients experiencing confusion and memory loss benefit from visual cues and simple, clear communication. Using symbols (such as pictures of a toilet for the restroom or a plate for the dining area) can help them navigate the environment more easily and reduce frustration.

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A nurse is collecting data from a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the medication is eﬀective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

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