Pharmacology and the Nursing
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
,TEST BANK
Question 1: Next-Generation NCLEX (NGN) Case Study (6-Item
Set)
Clinical Scenario
A 67-year-old male with a history of chronic heart failure
(HFrEF) and chronic kidney disease (CKD, Stage 3) is admitted to
the medical-surgical unit presenting with a 10-lb weight gain
over the past week, 3+ pitting bilateral lower extremity edema,
orthopnea, and coarse crackles in the lung bases bilaterally.
Current Vital Signs:
• BP: $162/94 \text{ mmHg}$
• HR: $92 \text{ bpm}$ (sinus rhythm)
• RR: $24 \text{ breaths/min}$
• $SpO_2$: 91% on room air
• Temp: $98.4^\circ\text{F}\ (36.9^\circ\text{C})$
Laboratory Results:
• Serum Potassium: $5.2 \text{ mEq/L}$
• Serum Sodium: $136 \text{ mEq/L}$
• BUN: $38 \text{ mg/dL}$
, • Serum Creatinine: $2.1 \text{ mg/dL}$ (Baseline: $1.5
\text{ mg/dL}$)
• eGFR: $32 \text{ mL/min}/1.73\text{m}^2$
The healthcare provider prescribes furosemide 80 mg IV push
once, followed by a continuous infusion if urine output is
insufficient.
Item 1.1: Matrix/Grid (Recognize & Analyze Cues)
Question Stem:
The nurse reviews the patient's presentation and laboratory
findings before administering the first dose of furosemide. Click
to specify whether each clinical parameter represents a
therapeutic indication for loop diuretic therapy or a high-risk
factor requiring close monitoring/potential intervention.
High-Risk Factor
Therapeutic
Clinical Parameter Requiring Close
Indication
Monitoring
Coarse crackles and
☐ ☐
orthopnea
Serum Creatinine
☐ ☐
$2.1 \text{ mg/dL}$ /
, High-Risk Factor
Therapeutic
Clinical Parameter Requiring Close
Indication
Monitoring
eGFR $32 \text{
mL/min}$
Serum Potassium
☐ ☐
$5.2 \text{ mEq/L}$
Blood Pressure
$162/94 \text{ ☐ ☐
mmHg}$
Correct Answers
• Coarse crackles and orthopnea: Therapeutic Indication
• Serum Creatinine $2.1 \text{ mg/dL}$ / eGFR $32 \text{
mL/min}$: High-Risk Factor Requiring Close Monitoring
• Serum Potassium $5.2 \text{ mEq/L}$: Therapeutic
Indication
• Blood Pressure $162/94 \text{ mmHg}$: Therapeutic
Indication
Comprehensive Rationale
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
,TEST BANK
Question 1: Next-Generation NCLEX (NGN) Case Study (6-Item
Set)
Clinical Scenario
A 67-year-old male with a history of chronic heart failure
(HFrEF) and chronic kidney disease (CKD, Stage 3) is admitted to
the medical-surgical unit presenting with a 10-lb weight gain
over the past week, 3+ pitting bilateral lower extremity edema,
orthopnea, and coarse crackles in the lung bases bilaterally.
Current Vital Signs:
• BP: $162/94 \text{ mmHg}$
• HR: $92 \text{ bpm}$ (sinus rhythm)
• RR: $24 \text{ breaths/min}$
• $SpO_2$: 91% on room air
• Temp: $98.4^\circ\text{F}\ (36.9^\circ\text{C})$
Laboratory Results:
• Serum Potassium: $5.2 \text{ mEq/L}$
• Serum Sodium: $136 \text{ mEq/L}$
• BUN: $38 \text{ mg/dL}$
, • Serum Creatinine: $2.1 \text{ mg/dL}$ (Baseline: $1.5
\text{ mg/dL}$)
• eGFR: $32 \text{ mL/min}/1.73\text{m}^2$
The healthcare provider prescribes furosemide 80 mg IV push
once, followed by a continuous infusion if urine output is
insufficient.
Item 1.1: Matrix/Grid (Recognize & Analyze Cues)
Question Stem:
The nurse reviews the patient's presentation and laboratory
findings before administering the first dose of furosemide. Click
to specify whether each clinical parameter represents a
therapeutic indication for loop diuretic therapy or a high-risk
factor requiring close monitoring/potential intervention.
High-Risk Factor
Therapeutic
Clinical Parameter Requiring Close
Indication
Monitoring
Coarse crackles and
☐ ☐
orthopnea
Serum Creatinine
☐ ☐
$2.1 \text{ mg/dL}$ /
, High-Risk Factor
Therapeutic
Clinical Parameter Requiring Close
Indication
Monitoring
eGFR $32 \text{
mL/min}$
Serum Potassium
☐ ☐
$5.2 \text{ mEq/L}$
Blood Pressure
$162/94 \text{ ☐ ☐
mmHg}$
Correct Answers
• Coarse crackles and orthopnea: Therapeutic Indication
• Serum Creatinine $2.1 \text{ mg/dL}$ / eGFR $32 \text{
mL/min}$: High-Risk Factor Requiring Close Monitoring
• Serum Potassium $5.2 \text{ mEq/L}$: Therapeutic
Indication
• Blood Pressure $162/94 \text{ mmHg}$: Therapeutic
Indication
Comprehensive Rationale
