The nurse is administering furosemide 40 mg PO to a client who has peripheral edema. Which method would the nurse use to best evaluate the client's response to this medication?

Assess breath sounds

Monitor serum protein levels

Assess peripheral pulses

Monitor daily weights

Answer and Explanation

The Correct Answer is D

D. Furosemide is a diuretic that works by increasing urine output, which in turn reduces fluid retention and swelling. By tracking the client's weight on a daily basis, the nurse can obtain a clear and consistent measure of how much fluid is being lost as a result of the medication.
A. Monitoring respiratory status but it may not be the most direct method for evaluating the effectiveness of furosemide in reducing peripheral edema.
B. Monitoring serum protein levels may provide information about the client's nutritional status and liver function, but it is not typically used as a direct measure of response to furosemide for peripheral edema.
C. Improvement in peripheral pulses may indicate a reduction in fluid overload and resolution of edema. However, changes in peripheral pulses may be influenced by factors other than diuresis, such as vascular disease or cardiac function.

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Correct Answer is D

Explanation

D. It offers the child a constructive way to release pent-up energy and frustration in a safe and non- confrontational manner. Physical activity can be a helpful tool in managing anger and disruptive behavior, as it allows the child to channel their emotions into a productive activity.
A. This option is not appropriate because it involves isolating the child in a locked room, which could further escalate the situation and may traumatize the child. Seclusion should only be used as a last resort in situations where the child or others are at risk of harm.
B. Physical restraints should only be used as a last resort in situations where the child poses an immediate danger to themselves or others. Using physical restraints can escalate the situation and may cause physical and psychological harm to the child.
C. Medication may be prescribed to manage symptoms of oppositional defiant disorder. However, using a PRN (as needed) anxiolytic medication to manage acute agitation should only be done under the guidance of a healthcare provider.

A. "My boyfriend is too passionate for me." B. "I know it was not my fault." C. "I'll just go on double dates from now on." D. "Next time I won't wear such a sexy dress."

Correct Answer is B

Explanation

B. This statement demonstrates progress and indicates that the client is beginning to take responsibility off themselves for the sexual assault. Acknowledging that the assault was not their fault is a crucial step in healing from trauma. It shows an acceptance of reality and a shift away from self-blame or feelings of guilt.
A. It may indicate that the client is still struggling to acknowledge the true nature of the assault and may not have fully processed their feelings and experiences related to the trauma.
C. This statement may suggest avoidance or attempts to control future situations to prevent similar experiences. While seeking support and safety measures can be beneficial, solely relying on external factors such as double dates to prevent sexual assault may not address underlying issues or promote healing from the trauma.
D. It suggests a continuation of internalized victim-blaming beliefs and may indicate that the client has not fully shifted away from feelings of guilt or responsibility for the assault.

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The nurse is administering furosemide 40 mg PO to a client who has peripheral edema. Which method would the nurse use to best evaluate the client's response to this medication?

Nursing Test Bank

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