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A patient who has recently begun taking captopril (Capoten) to treat HTN calls a clinic to report a persistent cough. The nurse will perform which action?
- A. Reassure the client that this is nothing to worry about and will diminish over time.
- B. Tell the patient to stop taking the drug immediately as this is a serious side effect of the drug.
- C. Schedule an appointment with the provider to discuss changing to an ARB.
- D. Instruct the patient to go to the emergency room immediately as this is a hypersensitivity reaction.
Correct Answer: C
Rationale: The correct answer is C. The nurse should schedule an appointment with the provider to discuss changing to an ARB (angiotensin II receptor blocker). Captopril, an ACE inhibitor, can cause a persistent cough as a common side effect due to increased bradykinin levels. Switching to an ARB, which works similarly but does not affect bradykinin levels, can resolve the cough while still effectively treating hypertension.
Explanation for other choices:
A: Incorrect. Persistent cough with captopril is not something to be disregarded as it can impact the patient's quality of life and adherence to treatment.
B: Incorrect. Stopping the medication abruptly without provider guidance can lead to uncontrolled hypertension.
D: Incorrect. A hypersensitivity reaction typically involves more severe symptoms beyond just a cough.
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A 54-year-old man has a myocardial infarction, resulting in left-sided heart failure. The nurse caring for the man is most concerned that he will develop edema in what area of the body.
- A. Peripheral.
- B. Pulmonary.
- C. Liver.
- D. Abdominal.
Correct Answer: B
Rationale: The correct answer is B: Pulmonary. Left-sided heart failure leads to the accumulation of fluid in the lungs, causing pulmonary edema. As the heart fails to pump effectively, blood backs up into the pulmonary circulation, leading to increased pressure in the blood vessels of the lungs. This results in fluid leakage into the alveoli, impairing gas exchange and causing symptoms like shortness of breath and coughing. Peripheral edema (choice A) occurs in right-sided heart failure due to fluid accumulation in the extremities. Liver congestion (choice C) can lead to hepatomegaly but is not the primary concern in this case. Abdominal edema (choice D) may occur in severe cases but is not as immediate a concern as pulmonary edema in left-sided heart failure.
A geriatric patient received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing action for the nurse receiving the patient on the regular unit?
- A. Administer a non-steroidal anti-inflammatory drug.
- B. Put side rails up and place bed in the lowest position.
- C. Encourage fluids.
- D. Create a restful dark environment.
Correct Answer: B
Rationale: The correct answer is B: Put side rails up and place bed in the lowest position. This is the priority nursing action as the geriatric patient who received a narcotic analgesic may experience drowsiness or confusion, increasing the risk of falls. By putting up the side rails and lowering the bed, the nurse is ensuring the patient's safety and preventing falls. Administering a non-steroidal anti-inflammatory drug (choice A) is not the priority as the patient's safety should be addressed first. Encouraging fluids (choice C) and creating a restful dark environment (choice D) are important but not as crucial as ensuring the patient's immediate safety.
The nurse is teaching a class on muscular coordination and explains it is the movement of what electrolyte that contributes to the process of muscle contraction and relaxation?
- A. Magnesium.
- B. Chloride.
- C. Calcium.
- D. Hydrogen.
Correct Answer: C
Rationale: The correct answer is C: Calcium. Calcium plays a crucial role in muscle contraction and relaxation. During muscle contraction, calcium ions bind to proteins in muscle fibers, allowing the actin and myosin filaments to slide past each other. This sliding action is what causes muscle contraction. When muscle relaxation is needed, calcium ions are pumped back into storage within the muscle cells, leading to relaxation. Magnesium (A), chloride (B), and hydrogen (D) do not directly influence muscle contraction and relaxation like calcium does.
The nurse is helping develop a plan of care for a patient that has advanced Alzheimer's disease. The patient will be taking a new medication. Which is a realistic goal for this patient?
- A. Exhibit ability to provide self-care.
- B. Show improved memory for recent events.
- C. Receive appropriate assistance for care needs.
- D. Demonstrate improved cognitive function.
Correct Answer: C
Rationale: The correct answer is C: Receive appropriate assistance for care needs. For a patient with advanced Alzheimer's disease, improving memory or cognitive function is unrealistic due to the progressive nature of the disease. Providing self-care may also be beyond their ability. Setting a goal for the patient to receive appropriate assistance for care needs is realistic and important for maintaining their quality of life and safety. This goal focuses on ensuring the patient's basic needs are met and promoting their overall well-being despite their cognitive decline. It prioritizes practical support and enhances the patient's quality of life.
What action does the nurse take during the intervention stage of the nursing process related to drug therapy? (Select all that apply)
- A. Analyze the data collected.
- B. Collect a nursing history.
- C. Determine medication effectiveness.
- D. Document the medication.
- E. Administer the medication.
Correct Answer: C,D,E
Rationale: During the intervention stage of the nursing process related to drug therapy, the nurse's actions include determining medication effectiveness (C) to ensure the treatment is achieving its intended outcomes. Documenting the medication (D) is crucial for maintaining accurate records of administration and monitoring. Administering the medication (E) is essential for providing the prescribed treatment to the patient. Analyzing data (A) is typically done during the assessment phase, not the intervention phase. Collecting a nursing history (B) is part of the assessment phase. Other choices are not directly related to the intervention stage of drug therapy.