# A nurse is preparing to administer furosemide 80 mg IV bolus to a 75-year-old client with pulmonary edema. The order does not specify a rate. Which action by the nurse is most appropriate?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374910&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PA

## Question

A nurse is preparing to administer furosemide 80 mg IV bolus to a 75-year-old client with pulmonary edema. The order does not specify a rate. Which action by the nurse is most appropriate?

## Option

1. Administer the dose as a rapid IV push over 30 seconds to facilitate immediate diuresis for the acute pulmonary edema.
2. Administer the dose IV at no faster than 4 mg per minute (≥20 minutes for 80 mg) to reduce the risk of ototoxicity. **✔ Correct answer**
3. Withhold the dose and contact the provider to clarify the rate, as administering without a specified rate is unsafe.
4. Dilute the dose in 50 mL of 5% dextrose solution and administer over 5 minutes to maximize the rate of diuresis.

**Correct answer: 2**

## Explanation

Furosemide IV rate — ototoxicity prevention
Rapid IV administration of loop diuretics is the principal risk factor for ototoxicity (tinnitus, transient or permanent hearing loss). The recommended maximum rate is 4 mg/min for adult bolus dosing — for an 80 mg dose, that means at least 20 minutes (or as a continuous infusion). High-dose IV loop in renal impairment, with concurrent aminoglycosides, in elderly clients, or pre-existing hearing loss further increases risk. Furosemide should not be mixed with dextrose in the same syringe (compatibility issue) and is incompatible with many drugs — flush before/after. The nurse does NOT hold a critical medication for missing rate information; the standard rate is well established and the institutional policy can be applied. Pushing over 30 seconds risks ototoxicity. Patient should be on a cardiac monitor with hourly I/O, BP, and pulse oximetry during therapy.

## In-depth explanation

Clinical reasoning summary
Furosemide IV rate — ototoxicity prevention
Rapid IV administration of loop diuretics is the principal risk factor for ototoxicity (tinnitus, transient or permanent hearing loss). The recommended maximum rate is 4 mg/min for adult bolus dosing — for an 80 mg dose, that means at least 20 minutes (or as a continuous infusion). High-dose IV loop in renal impairment, with concurrent aminoglycosides, in elderly clients, or pre-existing hearing loss further increases risk. Furosemide should not be mixed with dextrose in the same syringe (compatibility issue) and is incompatible with many drugs — flush before/after. The nurse does NOT hold a critical medication for missing rate information; the standard rate is well established and the institutional policy can be applied. Pushing over 30 seconds risks ototoxicity. Patient should be on a cardiac monitor with hourly I/O, BP, and pulse oximetry during therapy.

## Related questions

- [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=en)
- [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en)
- [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en)
- [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en)
- [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en)
- [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en)
- [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=en)
- [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=374910&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=374910&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=374910&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=374910&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=374910&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._