Nokea
A client on an ACE inhibitor reports a persistent cough. What is the nurse's best response?
- A. Reassure the client that the cough is a common side effect and is usually not serious.
- B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
- C. Advise the client to use a humidifier at night to relieve the cough.
- D. Suggest the client take an over-the-counter cough suppressant.
Correct Answer: B
Rationale: The correct answer is B because a persistent cough could indicate a serious side effect of ACE inhibitors, such as angioedema or bronchospasm. Instructing the client to report the cough to the healthcare provider is crucial to evaluate the need to discontinue the medication.
Choice A is incorrect as it downplays the potential seriousness of the cough. Choice C is incorrect because a humidifier may not address the underlying cause of the cough. Choice D is incorrect because using a cough suppressant without proper evaluation can mask symptoms of a serious side effect.
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Which condition is an infection that inflames the air sacs in one or both lungs, which may fill with fluid?
- A. Pneumonia
- B. Bronchitis
- C. Tuberculosis
- D. Cystic fibrosis
Correct Answer: A
Rationale: The correct answer is A: Pneumonia. Pneumonia is an infection that inflames the air sacs in the lungs, causing them to fill with fluid. This leads to symptoms such as cough, fever, and difficulty breathing. Bronchitis (B) is inflammation of the bronchial tubes, not the air sacs. Tuberculosis (C) is a bacterial infection that primarily affects the lungs but does not always lead to fluid accumulation. Cystic fibrosis (D) is a genetic disorder that affects the lungs but does not involve infection or fluid accumulation in the air sacs.
What structures hold up the AV valves and are anchored to the ventricular wall by the papillary muscles?
- A. Chordae tendineae
- B. Papillary muscles
- C. Semilunar valves
- D. Aortic valve
Correct Answer: A
Rationale: The correct answer is A: Chordae tendineae. These fibrous cords hold up the AV valves (mitral and tricuspid valves) and are anchored to the ventricular wall by the papillary muscles. The papillary muscles contract to prevent the AV valves from prolapsing into the atria during ventricular contraction. Choice B (Papillary muscles) is incorrect as they assist in the function but are not the structures that hold up the AV valves. Choices C (Semilunar valves) and D (Aortic valve) are incorrect as they are not directly involved in supporting the AV valves or anchored by the papillary muscles.
What is a condition characterized by the presence of air or gas in the pleural space, leading to the collapse of the lung?
- A. Pneumothorax
- B. Pulmonary embolism
- C. Pleural effusion
- D. Atelectasis
Correct Answer: A
Rationale: The correct answer is A: Pneumothorax. Pneumothorax is the presence of air or gas in the pleural space, causing the lung to collapse. This occurs when air enters the pleural space due to trauma or a lung condition. Pulmonary embolism (B) is a blockage of the artery in the lung by a blood clot. Pleural effusion (C) is the accumulation of fluid in the pleural space. Atelectasis (D) is the collapse of a part of or entire lung due to blockage or pressure. Therefore, the correct answer is A as it specifically describes the condition of air in the pleural space causing lung collapse.
The nurse is administering digoxin to a client. What is the most important parameter to check before administration?
- A. Heart rate
- B. Blood pressure
- C. Respiratory rate
- D. Oxygen saturation
Correct Answer: A
Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin is a medication that affects the heart. Monitoring the heart rate helps assess the client's cardiac function and determines if the medication can be safely given. Checking heart rate ensures that the client is not at risk for potential adverse effects such as bradycardia or arrhythmias. Blood pressure (B), respiratory rate (C), and oxygen saturation (D) are important parameters to monitor but are not as directly related to the action of digoxin on the heart.
A patient uses a mixed β-adrenergic blocking drug for treatment of migraine headaches. What effect might this drug have on BP and why?
- A. Decreased BP due to reduced cardiac output
- B. Increased BP due to unopposed α-adrenergic activity
- C. No effect on BP
- D. Decreased BP due to vasodilation
Correct Answer: A
Rationale: β-blockers reduce heart rate and contractility, lowering BP.