NURS 4581 Nursing of Adults with Complex Needs Exam 1 with Questions and Answers

NURS 4581 Nursing of Adults with Complex Needs Exam 1 with Questions and Answers A 68-year-old man, Mr. Kamau, presents with worsening shortness of breath, orthopnea, and bilateral leg swelling. He has a history of hypertension and previous myocardial infarction. On assessment, he has crackles in the lungs, jugular venous distension, and an S3 heart sound. His oxygen saturation is 90% on room air. The nurse anticipates interventions for acute decompensated heart failure. a. Administer IV fluids rapidly to improve circulation b. Encourage high-sodium diet to maintain blood pressure c. Place the patient in a supine position d. Administer loop diuretics as prescribed Correct Answer: D Rationale: Loop diuretics (e.g., furosemide) are first-line in acute heart failure to reduce fluid overload, improving pulmonary congestion and symptoms. Rapid IV fluids would worsen overload (a). High sodium intake increases fluid retention (b). Supine positioning worsens dyspnea; upright positioning is preferred (c). Mrs. Achieng, a 55-year-old woman, reports chest pain radiating to her left arm and jaw for the past 30 minutes. She is diaphoretic and anxious. Her ECG shows ST-segment elevation. She has a history of diabetes and hyperlipidemia. The nurse prepares for immediate intervention. a. Delay treatment until cardiac enzymes are confirmed b. Administer thrombolytic therapy or prepare for PCI c. Encourage ambulation to reduce anxiety d. Give a high-fat meal for energy Correct Answer: B