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A patient is prescribed a loop diuretic for the management of heart failure. Which electrolyte imbalance is most commonly associated with loop diuretic therapy?
- A. Hypercalcemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hypomagnesemia
Correct Answer: B
Rationale: Loop diuretics such as furosemide are commonly prescribed for the management of heart failure to reduce fluid overload and lower blood pressure by increasing the excretion of sodium and water. These medications promote the loss of potassium through increased urinary output. Hypokalemia, or low potassium levels in the blood, is the most common electrolyte imbalance associated with loop diuretic therapy. Potassium is an essential electrolyte for proper functioning of the heart, muscles, and nerves. Low potassium levels can lead to symptoms such as muscle weakness, cramps, and potentially life-threatening cardiac arrhythmias. Patients on loop diuretics are often monitored for potassium levels, and sometimes potassium supplements may be prescribed to prevent or correct hypokalemia.
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A patient is prescribed an antipsychotic medication for the management of schizophrenia. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypertension
- B. Hypoglycemia
- C. Extrapyramidal symptoms
- D. Hypercalcemia
Correct Answer: C
Rationale: Antipsychotic medications, especially first-generation antipsychotics, can cause extrapyramidal symptoms (EPS) as an adverse effect. EPS include symptoms such as muscle rigidity, tremors, akathisia (restlessness), and tardive dyskinesia (involuntary movements of the face and body). These symptoms are due to the medications' effects on the dopamine system in the brain. It is crucial for the nurse to monitor the patient closely for EPS because they can be uncomfortable, distressing, and may impact the patient's quality of life and medication adherence. Early recognition and management of EPS are essential to prevent further complications and improve the patient's overall well-being.
Vangie, 73 years old, comorbid with hypertension and asthma died of COVID Ariel grieved and mourned to the loss of his mother's untimely death. He is now aware that his mother is one of those 13, 425 deaths. The nurse will consider stage of grieving process is Ariel at what experiencing?
- A. Depression
- B. Denial and Anger
- C. Bargaining
- D. Acceptance
Correct Answer: A
Rationale: Ariel is likely experiencing the stage of depression in the grieving process. The stages of grief, according to the Kubler-Ross model, are denial, anger, bargaining, depression, and acceptance. In this scenario, Ariel has come to terms with his mother's death and is mourning her loss, which aligns with the stage of depression characterized by feelings of sadness, hopelessness, and intense sorrow. It is a normal part of the grieving process for individuals to experience these emotions as they process their loss.
A patient with a chronic viral infection demonstrates persistently elevated levels of CD8+ cytotoxic T cells in their blood. Which of the following mechanisms is most likely responsible for this observation?
- A. Activation-induced cell death (AICD)
- B. T cell exhaustion
- C. Thymic involution
- D. Antigenic variation
Correct Answer: B
Rationale: T cell exhaustion is a state of T cell dysfunction that arises during chronic viral infections or cancer. In the case of a chronic viral infection, the persistent exposure to viral antigens leads to continuous stimulation of CD8+ cytotoxic T cells. Over time, this sustained stimulation can lead to T cell exhaustion, characterized by the upregulation of inhibitory receptors, impaired effector functions, and reduced proliferative capacity. As a result, despite the elevated levels of CD8+ T cells in the blood, their function may be compromised, ultimately impacting the immune response against the viral infection. In contrast, activation-induced cell death (AICD) may contribute to T cell loss during chronic infections but would not explain the persistently elevated CD8+ T cell levels. Thymic involution refers to the age-related decline in thymus function, which is not directly related to the observed increase in CD8+ T cells. Antigenic
A patient is reluctant to discuss personal health issues due to embarrassment. What is the nurse's best approach to encourage open communication?
- A. Dismiss the patient's concerns and proceed with asking personal health questions.
- B. Provide the patient with privacy and assurance of confidentiality to create a safe space for discussion.
- C. Ignore the patient's reluctance and proceed with asking personal health questions regardless.
- D. Tell the patient that embarrassment is unnecessary and they should be open about their health issues.
Correct Answer: B
Rationale: Providing the patient with privacy and assurance of confidentiality is essential to create a safe and trusting environment for open communication. By assuring the patient that their information will be kept confidential, the nurse can help alleviate the patient's fears and encourage them to feel more comfortable discussing their personal health issues. Dismissing the patient's concerns (option A), ignoring their reluctance (option C), or telling them that their embarrassment is unnecessary (option D) are not effective approaches and may further hinder open communication. It is crucial for the nurse to create a supportive and nonjudgmental atmosphere to build trust with the patient and facilitate honest discussions about their health concerns.
A patient post-thyroidectomy develops signs of hypocalcemia, including tingling around the mouth and muscle cramps. Which action should the nurse take first?
- A. Administer oral calcium supplements
- B. Notify the healthcare provider
- C. Assess the patient's calcium level
- D. Encourage increased intake of dairy products
Correct Answer: C
Rationale: The first action the nurse should take when a patient post-thyroidectomy develops signs of hypocalcemia is to assess the patient's calcium level. By assessing the patient's calcium level through laboratory testing, the nurse can confirm the presence of hypocalcemia and determine the severity of the condition. This information will guide further interventions, such as administering calcium supplements or notifying the healthcare provider for additional management. It is important to confirm the diagnosis before proceeding with treatment to ensure appropriate and safe care for the patient.