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A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor for heart failure. Which laboratory parameter should the nurse monitor closely during ACE inhibitor therapy?
- A. Serum potassium levels
- B. Serum sodium levels
- C. Blood glucose levels
- D. Serum creatinine levels
Correct Answer: A
Rationale: The nurse should monitor serum potassium levels closely during ACE inhibitor therapy because ACE inhibitors can lead to an increase in serum potassium levels, known as hyperkalemia. ACE inhibitors block the conversion of angiotensin I to angiotensin II, which in turn decreases aldosterone secretion. Aldosterone normally acts in the kidneys to reabsorb sodium and water and excrete potassium. Therefore, when aldosterone secretion is decreased due to ACE inhibitor therapy, there can be an increase in potassium retention, potentially leading to hyperkalemia. Monitoring serum potassium levels is essential to prevent complications associated with hyperkalemia, such as cardiac arrhythmias.
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Nurse Rey with the members of the team. from a tertiary hospital is going for their annual outreach program Operation TULI". There were 3000 patients who came in the morning with only 4 doctors, 3 nurses and 1 pharmacist. Due to the volume of patients, Nurse Rey, was asked to participate in per forming circumcision with the rest of the doctors. Nurse Rey can be 1iable of committing
- A. assault
- B. tort
- C. invasion of privacy
- D. malpractice
Correct Answer: D
Rationale: Nurse Rey can be liable of committing malpractice by performing circumcisions without the proper training, qualifications, and legal authority to do so. Malpractice refers to negligence or failure to provide a standard level of care that results in harm to a patient. In this case, Nurse Rey participating in performing circumcisions may not have the necessary skills and expertise compared to the doctors who are trained to perform such procedures. This can lead to potential harm or complications for the patients, making it a case of malpractice.
In assessing the health condition of school children which of the following would be the finding common to this age group?
- A. Cancer and other malignancies
- B. Anemia and other blood disorders
- C. Lice and parasites
- D. Fractures and injuries
Correct Answer: B
Rationale: In assessing the health condition of school children, anemia and other blood disorders are more commonly observed in this age group compared to cancer, lice, parasites, fractures, and injuries. Anemia is a common health issue among children due to various factors such as poor nutrition, iron deficiency, and infections. Regular screening for anemia is important in school-age children to prevent long-term complications and to promote their overall health and well-being. While cancer, lice, parasites, fractures, and injuries can also occur in school children, anemia and blood disorders are more prevalent in this age group.
Which of the following is NOT covered in Patient's Bill of Rights?
- A. Refusal to treatment
- B. Informed consent
- C. Right to treatment
- D. Civil commitment
Correct Answer: D
Rationale: The Patient's Bill of Rights typically focuses on ensuring patients have the right to certain aspects of their healthcare, such as the right to refuse treatment, the right to informed consent, and the right to receive treatment. Civil commitment, on the other hand, refers to the legal process through which an individual is involuntarily placed in a psychiatric facility for evaluation and treatment. This issue is not typically addressed in the Patient's Bill of Rights, as it involves specific legal procedures rather than general patient rights.
Mr. C is an older patient with a known history of peripheral vascular disease. The nurse places a heating pad directly on the patient's lower leg to relieve muscle spasms. The heating pad causes a burn, the area becomes infected, and the patient eventually must have a skin graft. This is an example of which of the following?
- A. Malpractice
- B. Vicarious liability
- C. Assault
- D. Negligence
Correct Answer: D
Rationale: Negligence refers to the failure to take proper care in doing something. In this scenario, the nurse failed to exercise the standard of care expected in placing a heating pad directly on Mr. C's lower leg, knowing his history of peripheral vascular disease. This failure led to a burn and subsequent infection that required a skin graft for treatment. The actions of the nurse were negligent as they did not meet the expected standard of care, resulting in harm to the patient. This situation does not fit the definition of assault, malpractice, or vicarious liability, making negligence the most appropriate choice.
A patient with asthma experiences nocturnal cough, wheezing, and chest tightness several times per week. Which of the following medications is most appropriate for long-term control of asthma symptoms and prevention of exacerbations?
- A. Fluticasone/salmeterol (Advair)
- B. Albuterol (salbutamol)
- C. Ipratropium bromide (Atrovent)
- D. Prednisone
Correct Answer: A
Rationale: Fluticasone/salmeterol (Advair) is a combination medication consisting of an inhaled corticosteroid (fluticasone) and a long-acting beta-agonist (salmeterol). This combination medication is recommended for long-term control of asthma symptoms and for the prevention of exacerbations. Fluticasone reduces airway inflammation, while salmeterol helps to relax the muscles of the airways, improving breathing. Using this combination medication regularly can help manage asthma symptoms and reduce the risk of asthma attacks. It is not appropriate to use short-acting beta-agonists like albuterol (salbutamol) on a long-term basis for asthma control. Ipratropium bromide (Atrovent) is an anticholinergic bronchodilator that is more commonly used for chronic obstructive pulmonary disease (COPD