Page 1 of 25
Complex Care Lab Assignment |
Questions and Answers | 2026 Update
| 100% Correct - Molloy University.
1. Which medication does the nurse anticipate administering
FIRST?
a) Furosemide 40 mg IV push
b) Metoprolol 25 mg PO
c) Digoxin 0.125 mg IV
d) Spironolactone 25 mg PO
Answer: a) Furosemide 40 mg IV push
Rationale: IV loop diuretics (furosemide) are first-line for ADHF to
rapidly reduce preload and relieve pulmonary congestion. Beta-
blockers are contraindicated in acute decompensation. Digoxin is
second-line for symptom control.
,Page 2 of 25
2. The nurse notes the patient's potassium level is 3.1 mEq/L
one hour after furosemide administration. What is the priority
action?
a) Administer IV potassium chloride as ordered
b) Hold the next dose of furosemide
c) Recheck the potassium level in 4 hours
d) Administer sodium polystyrene sulfonate
Answer: a) Administer IV potassium chloride as ordered
Rationale: Loop diuretics cause hypokalemia, which increases the
risk of digoxin toxicity and arrhythmias. Potassium replacement is
urgent (K < 3.5). Rechecking delays treatment. Sodium polystyrene
sulfonate lowers potassium.
3. The nurse switches the patient to high-flow nasal cannula
at 40L/min and FiO2 60%. What clinical finding indicates
improvement?
a) Heart rate increases to 130
, Page 3 of 25
b) PaCO2 rises from 48 to 52
c) PaO2/FiO2 ratio increases from 150 to 250
d) Blood pressure drops to 80/50
Answer: c) PaO2/FiO2 ratio increases from 150 to 250
*Rationale: P/F ratio improvement indicates better oxygenation.
Normal >300, acute lung injury <300. Rising PaCO2
(hypercapnia) suggests worsening ventilation. Tachycardia and
hypotension are signs of deterioration.*
Scenario 2: A 55-year-old female presents with sudden onset
"tearing" chest pain radiating to the back. BP 150/90 in right
arm, BP 110/70 in left arm.
4. The nurse suspects which condition?
a) Acute myocardial infarction
b) Pulmonary embolism
c) Aortic dissection
d) Pericarditis
Complex Care Lab Assignment |
Questions and Answers | 2026 Update
| 100% Correct - Molloy University.
1. Which medication does the nurse anticipate administering
FIRST?
a) Furosemide 40 mg IV push
b) Metoprolol 25 mg PO
c) Digoxin 0.125 mg IV
d) Spironolactone 25 mg PO
Answer: a) Furosemide 40 mg IV push
Rationale: IV loop diuretics (furosemide) are first-line for ADHF to
rapidly reduce preload and relieve pulmonary congestion. Beta-
blockers are contraindicated in acute decompensation. Digoxin is
second-line for symptom control.
,Page 2 of 25
2. The nurse notes the patient's potassium level is 3.1 mEq/L
one hour after furosemide administration. What is the priority
action?
a) Administer IV potassium chloride as ordered
b) Hold the next dose of furosemide
c) Recheck the potassium level in 4 hours
d) Administer sodium polystyrene sulfonate
Answer: a) Administer IV potassium chloride as ordered
Rationale: Loop diuretics cause hypokalemia, which increases the
risk of digoxin toxicity and arrhythmias. Potassium replacement is
urgent (K < 3.5). Rechecking delays treatment. Sodium polystyrene
sulfonate lowers potassium.
3. The nurse switches the patient to high-flow nasal cannula
at 40L/min and FiO2 60%. What clinical finding indicates
improvement?
a) Heart rate increases to 130
, Page 3 of 25
b) PaCO2 rises from 48 to 52
c) PaO2/FiO2 ratio increases from 150 to 250
d) Blood pressure drops to 80/50
Answer: c) PaO2/FiO2 ratio increases from 150 to 250
*Rationale: P/F ratio improvement indicates better oxygenation.
Normal >300, acute lung injury <300. Rising PaCO2
(hypercapnia) suggests worsening ventilation. Tachycardia and
hypotension are signs of deterioration.*
Scenario 2: A 55-year-old female presents with sudden onset
"tearing" chest pain radiating to the back. BP 150/90 in right
arm, BP 110/70 in left arm.
4. The nurse suspects which condition?
a) Acute myocardial infarction
b) Pulmonary embolism
c) Aortic dissection
d) Pericarditis
