Nokea
A client with a history of hypertension is receiving enalapril (Vasotec). The nurse should monitor the client for which of the following side effects?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypercalcemia
- D. Hypokalemia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Enalapril, an ACE inhibitor, can lead to hyperkalemia as a side effect. ACE inhibitors can cause potassium retention by inhibiting aldosterone secretion, which may result in elevated potassium levels. Hypoglycemia (choice B) is not typically associated with enalapril use. Hypercalcemia (choice C) is also not a common side effect of enalapril. Hypokalemia (choice D) is the opposite of what is expected with enalapril, as it tends to cause potassium retention.
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While discussing the science of nursing, the nurse identifies the domain of nursing theory. Which linkages should the nurse provide to describe nursing's paradigm?
- A. The person, the environment or situation, and health.
- B. Stress reduction, self-care, and a systems model.
- C. Curative care, restorative care, and terminal care.
- D. Self-actualization, fundamental needs, and belonging.
Correct Answer: A
Rationale: The correct answer is A: 'The person, the environment or situation, and health.' In nursing theory, the paradigm includes these core components: the person receiving care, the environment or situation influencing care, and the goal of achieving optimal health outcomes. Choices B, C, and D are incorrect as they do not align with the fundamental aspects of nursing theory and its paradigm.
As a client who is terminally ill has been receiving high doses of an opioid analgesic for the past month and becomes unresponsive to verbal stimuli as death approaches, what orders would the nurse expect from the healthcare provider?
- A. Decrease the analgesic dosage by half
- B. Discontinue the analgesic
- C. Continue the same analgesic dosage
- D. Prescribe a less potent drug
Correct Answer: C
Rationale: Continuing the same dosage of analgesic is appropriate to manage pain effectively as death nears and the client becomes unresponsive. The primary goal of palliative care in end-of-life situations is to ensure comfort, regardless of the client's level of consciousness. Decreasing the analgesic dosage or discontinuing it could lead to inadequate pain relief, which goes against the principles of palliative care. Prescribing a less potent drug may also compromise pain management in this critical stage. Therefore, maintaining the same analgesic dosage is the most appropriate action to provide comfort and alleviate suffering.
The nurse is assigned to a client with Parkinson's disease. Which findings would the nurse anticipate?
- A. Non-intention tremors and urgency with voiding
- B. Echolalia and a shuffling gait
- C. Muscle spasm and a bent-over posture
- D. Intention tremor and jerky movement of the elbows
Correct Answer: B
Rationale: The correct answer is B. Echolalia (repeating others' words) and a shuffling gait are common symptoms of Parkinson's disease. These symptoms result from the degeneration of the basal ganglia in the brain that controls movement and speech. Choice A is incorrect because non-intention tremors are not typically associated with Parkinson's disease. Choice C is incorrect as muscle spasm and a bent-over posture are not classic manifestations of Parkinson's disease. Choice D is incorrect since intention tremors and jerky movement of the elbows are not characteristic of Parkinson's disease.
Which of the following is the most effective way to prevent the spread of communicable diseases in a community?
- A. Regular health check-ups
- B. Isolation of infected individuals
- C. Immunization programs
- D. Public health education
Correct Answer: C
Rationale: Immunization programs are the most effective way to prevent the spread of communicable diseases. Vaccinations help build immunity against specific diseases, reducing the likelihood of an outbreak. Regular health check-ups (Choice A) are important for individual health but do not directly prevent the spread of diseases on a community level. Isolation of infected individuals (Choice B) is a containment measure rather than prevention for the entire community. Public health education (Choice D) is valuable in raising awareness but may not be as effective as immunization programs in directly preventing the spread of communicable diseases.
What title should be given to this professional role in occupational health? A registered nurse who develops researchable questions, conducts research, and communicates the findings to occupational and environmental health professionals, other peers, and the public.
- A. manager
- B. researcher
- C. clinician/practitioner
- D. health promotion specialist
Correct Answer: B
Rationale: The correct answer is 'B: researcher.' In this context, the individual is primarily involved in developing research questions, conducting research, and disseminating findings, which aligns with the responsibilities of a researcher. Choice 'A: manager' is incorrect because the role described does not primarily involve managerial duties. Choice 'C: clinician/practitioner' is also incorrect as the focus is on research activities rather than direct clinical practice. Choice 'D: health promotion specialist' does not encompass the full scope of responsibilities described in the scenario.