Difficulty: Medium
Average Score: 75%
Simulated
Passage / Scenario
Diagnostic ResultHbA1C 6.2% (less than 7%)
Blood glucose 102 mg/dL (82 to 115 mg/dL)
Hemoglobin 14.2 g/dL (14.2 to 18 g/dL)
Hematocrit 42.6% (42% to 52%)
Total WBC count 6,000/mm3 (5,000 to 10,000/mm3)
HDL 35 mg/dL (greater than 45 mg/dL)
LDL 142 mg/dL (less than 130 mg/dL)
Brain natriuretic peptide (BNP) 352 pg/mL (less than 100 pg/mL)
Chest x-ray: Shows cardiomegaly and bibasilar pleural congestion.
Medication Administration Record
Metformin 850 mg PO q am
Digoxin 0.25 mg PO q am
Carvedilol 25 mg PO bid
Furosemide 40 mg IV bolus once now
Vital Signs
BP 146/98 mm Hg
Temperature 36.8┬║ C (98.2┬║ F)
Pulse rate 106/min
Respirations 24/min
O2 saturation 94% on 2 L/min nasal cannula
A nurse is preparing to care for an 84-year-old male client who is being admitted to a medical unit from a provider's office. The nurse reviews the client's medical records to prepare the client's plan of care. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Rationale
Elevated BNP, cardiomegaly, and pleural congestion indicate heart failure. Elevating the bed and a low-sodium diet manage symptoms, while monitoring urinary output and blood pressure assesses treatment efficacy.