An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?

A coronary artery bypass procedure was performed in 1995.

Suﬀered with depression following death of spouse in 1999.

Digoxin and furosemide daily since 1996.

A Colonoscopy was performed for routine screening six months ago.

Answer and Explanation

The Correct Answer is C

Digoxin is a medication commonly used to treat heart failure by strengthening the heart's contractions and slowing down the heart rate. However, it can also cause nausea, vomiting, and loss of appetite, especially when levels in the body are too high. Furosemide is a diuretic medication that helps to remove excess ﬂuid from the body, which is often necessary in heart failure. However, it can also cause electrolyte imbalances, such as low potassium levels, which can contribute to nausea and vomiting.

Therefore, in a client with heart failure who is experiencing these symptoms, it is important to assess their medication regimen, including dosages and serum levels, to ensure that they are not experiencing medication side eﬀects or toxicity.

Adjustments may need to be made to the client's medication regimen to manage symptoms eﬀectively and prevent further complications. Options (a), (b), and (d) do not have as direct a correlation to the current symptoms and would not have the same level of significance when planning care for this client.

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Correct Answer is B

Explanation

Before administering the first dose of any antibiotic, it is essential to obtain a culture and sensitivity test to identify the causative organism and determine the most eﬀective antibiotic to use. Administering a broad- spectrum antibiotic before obtaining a culture and sensitivity test may lead to the development of antibiotic-resistant strains of bacteria, making it more difficult to treat the infection in the future.

Options a, c, and d are not as important as obtaining a culture and sensitivity test. Monitoring for signs of sodium and ﬂuid retention, irrigation and topical antibiotic application to the wound area, and completing blood count and serum electrolytes are important, but obtaining a culture and sensitivity test is the priority.

A. Platelets B. Glucose C. Osmolality D. Calcium

Correct Answer is C

Explanation

Diabetes insipidus is a condition in which the kidneys are unable to conserve water, leading to excessive thirst and urination. It is treated with antidiuretic hormone (ADH), which helps the kidneys retain water and reduce urine output. When caring for a client with diabetes insipidus who is receiving ADH intranasally, it is important for the nurse to monitor the client’s serum osmolality.

Osmolality is a measure of the concentration of particles in a solution and can provide information about the client’s hydration status.

Monitoring serum osmolality can help determine if the ADH therapy is eﬀective in managing the client’s diabetes insipidus.

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An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

On admission, the healthcare provider describes a broad spectrum of antibiotic, ticarcillin for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

Correct Answer is B

Explanation

When caring for a client with diabetes insipidus who is receiving antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor?

Correct Answer is C

Explanation

The nurse is caring for a client who is taking diclofenac, an NSAID drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client’s serum laboratory values is most important for the nurse to review?

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