Complete the following sentence: Given the patient’s symptoms of dyspnea and fatigue, the nurse anticipates the primary care provider may increase the dose of (medication class) to help reduce fluid overload.

Beta blockers

Diuretics

Ace Inhibitors

Answer and Explanation

The Correct Answer is B

Choice A reason: Beta blockers like metoprolol reduce heart rate and demand, improving heart failure long-term. They don’t directly reduce fluid overload causing dyspnea and fatigue, focusing instead on cardiac remodeling, not acute volume relief.

Choice B reason: Diuretics like furosemide increase urine output, reducing fluid overload in heart failure. They directly relieve dyspnea and fatigue by lowering preload and pulmonary congestion, the most effective class for these symptoms.

Choice C reason: ACE inhibitors like lisinopril ease vascular resistance, aiding heart failure. They reduce fluid indirectly via aldosterone suppression, but diuretics act faster on acute overload, making them secondary for immediate symptom relief.

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Correct Answer is B

Explanation

Choice A reason: Metabolic alkalosis shows pH >7.45 with HCO3- >26 mEq/L from base excess. Here, pH is 7.48, but HCO3- is normal at 24 mEq/L, ruling out metabolic cause. PaO2 of 55 mmHg indicates hypoxemia, but the primary issue isn’t metabolic.

Choice B reason: Respiratory alkalosis occurs with pH >7.45 and PaCO2 <35 mmHg from hyperventilation. Here, pH is 7.48, PaCO2 is 28 mmHg, and HCO3- is normal, confirming respiratory etiology. PaO2 of 55 mmHg shows hypoxemia, matching this acute ventilatory pattern.

Choice C reason: Metabolic acidosis has pH <7.35 and HCO3- <22 mEq/L from acid gain. Here, pH is 7.48 and HCO3- is 24 mEq/L, contradicting acidosis. PaO2 of 55 mmHg indicates hypoxemia, but the acid-base status is alkalotic, not acidic.

Choice D reason: Respiratory acidosis features pH <7.35 and PaCO2 >45 mmHg from CO2 retention. Here, pH is 7.48 and PaCO2 is 28 mmHg, showing CO2 loss, not retention. Hypoxemia (PaO2 55 mmHg) is present, but the pattern is alkalotic.

A. Instill a vasoconstrictor medication into the affected nare. B. Pack the affected nare tightly with an epistaxis balloon. C. Obtain silver nitrate that may be needed for cauterization. D. Apply squeezing pressure to the nostrils for 10 minutes.

Correct Answer is D

Explanation

Choice A reason: Vasoconstrictors like oxymetazoline shrink vessels, aiding epistaxis control. It’s a secondary step requiring preparation, not first, as direct pressure is faster, non-invasive, and effective for initial hemostasis in most anterior bleeds.

Choice B reason: Packing with a balloon stops severe bleeding but is invasive and later in management. Pressure is the first, simpler action; packing escalates care unnecessarily before basic measures are tried in acute epistaxis.

Choice C reason: Silver nitrate cauterizes vessels, useful for persistent bleeding. It’s not first, requiring setup and assessment after pressure fails, as most epistaxis resolves with compression, making this a subsequent intervention.

Choice D reason: Squeezing nostrils compresses Kiesselbach’s plexus, stopping most anterior nosebleeds within 10 minutes. It’s the immediate, evidence-based first action, non-invasive, and effective, prioritizing rapid control before escalating to other methods.

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Complete the following sentence: Given the patient’s symptoms of dyspnea and fatigue, the nurse anticipates the primary care provider may increase the dose of (medication class) to help reduce fluid overload.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Correct Answer is B

Explanation

Which action would the nurse take first when a patient develops epistaxis (nose bleed)?

Correct Answer is D

Explanation

The nurse is reviewing the patient’s recent symptoms and lab results. Which of the following symptoms or findings suggest worsening heart failure? (Select all that apply)

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