Sharpen Your Decision-Making with High-Yield Medical Scenarios 1. Scenario: A 62-year-old patient with a history of heart failure is admitted with pulmonary edema. The nurse is administering intravenous Furosemide. Which clinical finding most accurately indicates the medication is achieving its intended therapeutic effect? A. Reduction in systolic blood pressure. B. Increase in urine output and decrease in lung crackles. C. Serum potassium level of 4.2 mEq/L. D. Improvement in the patient's appetite. Rationale: (B) Furosemide is a loop diuretic used to reduce fluid overload. The clinical goal in pulmonary edema is to remove excess fluid from the lungs. Increased urine output and clearer breath sounds (decreased crackles) directly indicate successful diuresis and reduction of pulmonary congestion. 2. Scenario: A patient is diagnosed with a deep vein thrombosis (DVT) in the right calf. Which nursing intervention is essential to prevent a life-threatening complication? A. Massaging...
Master Complex Patient Care with Evidence-Based Rationales 1. Scenario: A 68-year-old male is 24 hours post-abdominal surgery. The nurse notes the patient is suddenly restless, tachycardic (115 bpm), and his blood pressure has dropped to 94/60 mmHg. The abdominal dressing is dry, but the patient complains of severe back pain. What is the nurse's most appropriate initial action? A. Administer the prescribed PRN analgesic for back pain. B. Increase the IV fluid rate as per standing orders. C. Assess the patient for signs of internal hemorrhage and notify the surgeon. D. Re-position the patient to a High-Fowler’s position. Rationale: Restlessness, tachycardia, and hypotension are classic "shock" indicators. Since the dressing is dry, the nurse must suspect internal hemorrhage (C), especially with the complaint of back pain which could indicate retroperitoneal bleeding. Assessment must precede intervention. 2. Scenario: A patient is receiving a continuous infusion of Magne...