The physician has written orders for the client with Excess Fluid Volume. The client's morning assessment includes bounding peripheral pulses, weight gain of 2 pounds, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time?

Correct Answer: D

Rationale: The correct answer is D: Administer furosemide (Lasix) 40 mg IV push. This is the priority because the client is showing signs of fluid volume excess, such as weight gain, pitting edema, and crackles, which indicate fluid overload in the lungs. Furosemide is a loop diuretic that helps to remove excess fluid from the body quickly, making it crucial in managing excess fluid volume in this situation. Weighing the client daily (A) is important but not as urgent as addressing the immediate symptoms of fluid overload. Maintaining accurate intake and output (B) is essential for overall fluid balance but does not address the immediate excess fluid volume. Fluid restriction (C) may be needed in the long term, but immediate intervention with furosemide is necessary to prevent worsening of symptoms and potential complications.

Correct Answer: D

Rationale: The correct answer is D: Chronic renal insufficiency. Chronic renal insufficiency can lead to metabolic acidosis or alkalosis due to impaired kidney function in regulating acid-base balance. Renal insufficiency can cause retention or loss of bicarbonate ions, leading to imbalances. Myocardial infarction, occasional use of antacids, and shortness of breath with extreme exertion are not direct risk factors for acid-base imbalances.

Correct Answer: B

Rationale: The correct answer is B because exercise can improve circulation and cardiovascular fitness by reducing the heart rate and blood pressure. When we exercise, our heart becomes more efficient at pumping blood, leading to a lower resting heart rate and reduced blood pressure. This helps improve circulation and strengthens the cardiovascular system. Explanation for why the other choices are incorrect: A: The number of small blood vessels throughout the body - Exercise actually promotes the growth of new blood vessels, improving circulation. C: High-density lipoproteins (HDL) in the blood - Exercise can increase HDL levels, which is beneficial for heart health. D: The body’s breathing capacity - Exercise can improve lung function and increase breathing capacity, but it is not directly related to circulation or cardiovascular fitness.

Correct Answer: A

Rationale: The correct answer is A: During the fourth to the seventh menstrual cycle day. This is because breasts are least likely to be swollen or tender during this time, allowing for a more accurate examination. Choice B is incorrect as regular monthly examinations are recommended. Choice C can be done while standing up or lying down. Choice D is incorrect as breasts may be more tender and swollen closer to the menstrual cycle, making it harder to detect abnormalities.

Correct Answer: A

Rationale: Rationale: A: Discharge planning should begin on the day of admission to ensure a smooth transition. This early start allows for comprehensive assessment and coordination of post-discharge needs. B: Waiting until after the acute crisis is resolved may lead to rushed planning and potential gaps in care. C: Discharge planning should not solely rely on the physician's discharge order as it may not address all aspects of the patient's needs. D: Patient readiness is important, but starting planning early ensures sufficient time for assessment and interventions.