A 75-year-old individual is admitted with a diagnosis of left-sided heart failure and is administered Lasix 80 mg by slow IV push. Which nursing assessment indicates that the Lasix (furosemide) is NOT having the desired effect?

Correct Answer: A

Rationale: The correct answer is A: Oliguria. In a patient with heart failure, Lasix is given to promote diuresis and reduce fluid overload. Oliguria, or decreased urine output, indicates that the Lasix is not effectively removing excess fluid from the body. This is a crucial assessment as it may suggest worsening heart failure or possible renal insufficiency. Explanation for why other choices are incorrect: B: Decrease in blood pressure - This could be an expected effect of Lasix, as it helps reduce fluid volume, leading to decreased blood pressure. C: Absence of crackles - This indicates that there is a reduction in pulmonary congestion, which is a desired effect of Lasix. D: Polydipsia - This refers to increased thirst, which may be a side effect of Lasix but does not necessarily indicate treatment failure.

Correct Answer: A

Rationale: The correct answer is A: Phenylephrine. It is a vasoconstrictor that increases blood pressure by constricting blood vessels. This makes it effective in managing mild to moderate hypotension by raising blood pressure. Amiodarone (B) is an antiarrhythmic drug, not used for hypotension. Ibutilide (C) is used for atrial fibrillation/flutter, not hypotension. Milrinone (D) is a phosphodiesterase inhibitor used for heart failure, not hypotension. Therefore, A is the correct choice for managing hypotension.

Correct Answer: A

Rationale: The correct answer is A: For congestive heart failure. Milrinone is a phosphodiesterase inhibitor that helps improve cardiac contractility and output, making it a suitable treatment for congestive heart failure. It is used in patients with reduced ejection fraction and symptoms of heart failure. Choices B, C, and D are incorrect because milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is important for the nurse to understand the specific indications for milrinone to ensure safe and effective administration to the client.

Correct Answer: B

Rationale: The correct answer is B: Increases heart rate. Non-cardio-selective beta blockers block beta-1 and beta-2 receptors, leading to unopposed alpha receptor stimulation, causing increased heart rate. Choice A is incorrect as beta blockers typically lower blood pressure. Choice C is incorrect as beta blockers can cause bradycardia, not sinus bradycardia specifically. Choice D is incorrect because non-cardio-selective beta blockers can exacerbate asthma due to beta-2 receptor blockade.

Correct Answer: A

Rationale: The correct answer is A: Atrial flutter. Calcium channel blockers are used to treat atrial arrhythmias by slowing down the conduction of electrical signals in the heart, specifically in the atria. This helps in controlling the heart rate and rhythm in conditions like atrial flutter. B: Ventricular tachycardia is incorrect because calcium channel blockers primarily affect the atria, not the ventricles where ventricular tachycardia originates. C: Frequent PVCs is incorrect as calcium channel blockers are not typically used to treat premature ventricular contractions (PVCs). D: Sinus bradycardia is incorrect because calcium channel blockers can further slow down the heart rate, potentially worsening sinus bradycardia.