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. 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.

A. The client has a harmful gene mutation which puts him at a higher risk for cancer in the future. B. The client will need additional testing to determine if he has cancer. C. The client has prostate cancer. D. The client has benign prostatic hyperplasia (BPH).

Correct Answer is B

Explanation

A. PSA levels themselves do not indicate a gene mutation. Elevated PSA levels are primarily associated with prostate conditions rather than genetic mutations. While certain genetic mutations can predispose individuals to prostate cancer, PSA alone does not diagnose genetic mutations.
B. Elevated PSA levels can indicate the possibility of prostate cancer, but further testing is necessary to confirm the diagnosis. Additional tests may include a digital rectal exam (DRE), imaging studies (such as ultrasound or MRI), and a prostate biopsy.
C. Elevated PSA levels can suggest prostate cancer, but they do not definitively diagnose it. Prostate cancer can only be confirmed through a biopsy that identifies cancerous cells in the prostate tissue.
D. BPH is a non-cancerous enlargement of the prostate gland that commonly occurs in older men. While BPH can cause urinary symptoms similar to prostate cancer, elevated PSA levels are not typically associated with BPH alone. PSA elevation is more specific to prostate cancer but can also occur with other prostate conditions.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

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