HESI PN EXIT EXAM VERSION 3/ RECENT UPDATE / HESI EXIT EXAM QUESTIONS AND VERIFIED SOLUTIONS ALREADY GRADED A+
13) During assessment of a client in the intensive care unit, the nurse notes that the client's ARE CLEAR UPON AUSCULTATION, but jugular vein distention and muffled heart sounds are present. Which intervention should the nurse implement? A. Prepare the client for a pericardial tap. B.Administer intravenous furosemide (Lasix). C. Assist the client to cough and breathe deeply. D. Instruct the client to restrict the oral fluid intake. ANSWER: A. Prepare the client for a pericardial tap
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