Nokea
A client with primary hypertension is prescribed terazosin (Hytrin) to treat this condition. What is the mechanism of action of this drug?
- A. Prevents conversion of angiotensin I to angiotensin II
- B. Prevents beta-receptor stimulation in the heart
- C. Inhibits the flow of calcium ions across the cell membrane of vascular tissue and cardiac cells
- D. Blocks alpha-receptors in the vascular smooth muscle
Correct Answer: D
Rationale: Terazosin is an alpha-1 adrenergic receptor blocker. By blocking alpha-1 receptors in the vascular smooth muscle, terazosin causes dilation of both arteries and veins, leading to reduced peripheral vascular resistance and decreased blood pressure. This dilation effect is achieved by preventing the binding of norepinephrine to alpha-1 receptors, thereby inhibiting vasoconstriction. Terazosin is commonly used in the treatment of hypertension to help lower blood pressure by reducing the workload on the heart and improving blood flow to organs and tissues.
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A client diagnosed with a deep vein thrombosis (DVT) is receiving intravenous heparin. Which is the priority outcome for this client?
- A. The client will not disturb the intravenous infusion.
- B. The client will comply with dietary restrictions.
- C. The client will not experience bleeding.
- D. The client will keep the right leg elevated on two pillows.
Correct Answer: C
Rationale: The priority outcome for a client with deep vein thrombosis (DVT) receiving intravenous heparin is to prevent bleeding. Heparin is an anticoagulant medication used to prevent the formation of blood clots, but one of its potential side effects is bleeding due to its ability to prevent blood clotting. It is crucial to closely monitor the client for signs of bleeding while on heparin therapy, such as easy bruising, black or tarry stools, blood in the urine, or excessive bleeding from wounds. Preventing bleeding is essential to avoid complications associated with anticoagulant therapy.
A patient has developed a paralytic ileus following recent abdominal surgery. What is the most important nursing action when caring for this patient?
- A. Monitor bowel sounds every hour
- B. Maintain the patient on strict bed rest
- C. Ensure the nasogastric tube is functioning
- D. Ensure that the patient is given a clear liquid diet
Correct Answer: C
Rationale: Ensuring that the nasogastric tube is functioning is the most important nursing action when caring for a patient with a paralytic ileus. A paralytic ileus is a condition where there is a temporary paralysis of the intestine, leading to a lack of bowel motility. This can result in a buildup of gas and fluids in the intestines, causing abdominal distension, pain, and potential complications.
After a stroke, sensory-perceptual changes increase the client's risk for what?
- A. Aspiration
- B. Injury
- C. Bleeding
- D. Infection
Correct Answer: B
Rationale: After a stroke, sensory-perceptual changes such as impaired proprioception, altered sensation, and decreased awareness of the affected side can increase the client's risk for injury. These changes can result in difficulties with balance, coordination, and spatial awareness, making the individual more prone to falls and accidents. It is important to implement safety measures and interventions to minimize the risk of injury in these clients, such as providing a structured environment, using assistive devices, and encouraging regular monitoring and assistance as needed.
The nurse evaluates teaching provided to a patient with a newly created ileal diversion with a continent reservoir. Which patient behavior indicates teaching has been effective?
- A. Demonstrates care for the collection device
- B. Demonstrates self-catheterization of the stoma
- C. Identifies factors contributing to the risk for bladder cancer
- D. States the importance of promptly reporting cloudy urine to the physician
Correct Answer: A
Rationale: In a patient with a newly created ileal diversion with a continent reservoir, demonstrating care for the collection device signifies that the patient has understood the importance of maintaining hygiene and proper management of the device. This behavior indicates that the teaching provided by the nurse has been effective in helping the patient take care of the diversion and prevent complications such as infection or skin irritation. Understanding how to care for the collection device is crucial for the patient's overall well-being and quality of life with the continent reservoir.
The nurse is planning discharge teaching to a client with diabetes who has a large wound. Which is the priority action for the nurse prior to initiating teaching with this client?
- A. Asking the client to state what is known about the current dressing changes
- B. Teaching the client how to take blood sugars
- C. Assessing the client's ability to self-administer insulin
- D. Determining the client's reaction to having diabetes
Correct Answer: A
Rationale: The priority action for the nurse before initiating discharge teaching with a client with diabetes and a large wound is to assess the client's current knowledge regarding dressing changes. This step is crucial as it helps the nurse to understand the client's baseline understanding and skills related to wound care, which will guide the teaching process effectively. By asking the client to state what they know about the current dressing changes, the nurse can identify any knowledge gaps or misconceptions that need to be addressed. This assessment will ensure that the teaching is tailored to the client's specific needs and promotes successful wound healing and overall diabetes management.