A patient arrives to the emergency department with crackles audible in the bilateral lungs, and 3+ pitting edema to his lower extremities. The provider orders furosemide 40 mg slow IV push to be given one time. Which of the following assessment findings requires the nurse to hold the medication and contact the provider for further instructions?

Sodium 149 mEq/L

Blood pressure 90/53 mmHg

Client is incontinent of urine

Potassium 53 mEq/L

Answer and Explanation

The Correct Answer is B

A.   Hypernatremia can indicate dehydration or other electrolyte imbalances. Furosemide can further affect electrolyte balance, especially sodium and potassium. However, this sodium level is only slightly elevated and may not necessarily require immediate action regarding furosemide administration.
B.   Furosemide is a diuretic that can further decrease blood pressure due to its effects on fluid volume reduction. Administering it to a patient with already low blood pressure could potentially lead to significant hypotension and compromise perfusion to vital organs.
C.   While incontinence itself may not directly contraindicate furosemide administration, it could indicate underlying issues such as bladder dysfunction or fluid overload that need further evaluation. This finding alone would not necessarily require holding the medication, but it warrants further assessment and consideration in the clinical context.
D.   Normal serum potassium levels typically range from 3.5-5.0 mEq/L. A level of 5.3 mEq/L indicates hyperkalemia (elevated potassium). While this potassium level is mildly elevated, it would not be a reason on its own to hold furosemide. Monitoring potassium levels closely and potentially adjusting potassium

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Correct Answer is C

Explanation

A. A vegetarian diet typically does not directly contribute to bronchoconstriction. In fact, a diet rich in fruits and vegetables may provide antioxidants and anti-inflammatory compounds that can be beneficial for respiratory health. Therefore, this option is less likely to be a cause of the client's bronchoconstriction.
B. Rosuvastatin (and other statins) are generally well-tolerated, but some individuals may experience respiratory side effects, including cough or shortness of breath. However, bronchoconstriction as a direct side effect of statins is uncommon and typically not a primary concern unless there is a rare hypersensitivity reaction.
C. Propranolol is a non-selective beta-blocker that can lead to bronchoconstriction, particularly in individuals with asthma or other respiratory conditions. Beta-blockers can block beta-2 receptors in the lungs, potentially causing constriction of the airways and worsening of respiratory symptoms.
D. Acetaminophen (paracetamol) is generally considered safe and does not typically cause bronchoconstriction. It is a non-steroidal anti-inflammatory drug (NSAID) that works differently from medications like beta-blockers, which directly affect the airways.

A. Encourage spicy and highly-seasoned foods to improve intake. B. Administer loperamide prophylactically to prevent nausea. C. Provide frequent, thorough pain assessments. D. Administer the chemotherapy medication through an 18 gauge peripheral line.

Correct Answer is C

Explanation

A. During chemotherapy, many patients experience nausea, vomiting, and changes in taste or appetite. Spicy and highly-seasoned foods can exacerbate gastrointestinal symptoms and may not be well tolerated. It's generally recommended to encourage bland, easy-to-digest foods to help maintain adequate nutrition and reduce discomfort.
B. Loperamide is not used to prevent nausea; rather, it is an antidiarrheal medication used to treat diarrhea, which can be a side effect of chemotherapy. Nausea prevention is typically managed with antiemetic medications such as ondansetron, metoclopramide, or others prescribed based on the patient's specific needs and chemotherapy regimen.
C. Pain management is an essential aspect of caring for oncology patients, including those receiving chemotherapy. Cancer and its treatment can cause pain directly or indirectly (such as from procedures or complications). Regular and thorough pain assessments allow for timely intervention and improvement in the client's comfort and quality of life.
D. Chemotherapy medications are typically administered through central venous access devices (e.g., central lines, PICC lines) rather than through peripheral veins. This is because chemotherapy drugs can be vesicants (causing tissue damage if they leak out of the vein) or irritants to smaller peripheral veins.
Using a larger gauge peripheral line (e.g., 18 gauge) is not standard practice for administering chemotherapy due to the potential risks and complications associated with peripheral administration.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is obtaining an admission history on a client who has possible asthma with new-onset wheezing and shortness of breath. Which information may be a cause of the client's bronchoconstriction?

Correct Answer is C

Explanation

A nurse on an oncology unit is caring for a client who is receiving intravenous chemotherapy for the treatment of advanced colon cancer. Which of the following items should be included in the plan of care for this client?

Correct Answer is C

Explanation

An older adult client who is having difficulty passing urine is found to have elevated levels of prostate-specific antigen (PSA). The nurse understands that this finding indicates which of the following?

A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

The classic manifestations associated with Parkinson's disease are tremor, rigidity, bradykinesia, and postural instability. The nurse understands that a finding related to postural instability includes which of the following?

A nurse on a telemetry unit receives change-of-shift report on four clients. Which of the following clients should the nurse assess first?

The nurse is reviewing the results of the client's echocardiogram and notes that the ejection fraction is 35%. The nurse anticipates that which of the following medications will be ordered to increase the client's cardiac output?

A client who has been diagnosed with chronic stable angina is placed on multiple medications to manage the condition. The nurse understands that the client is receiving rosuvastatin for which reason?