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A patient with a history of congestive heart failure is prescribed furosemide. Which electrolyte imbalance is the patient at risk for developing with furosemide therapy?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia nd potassium. Therefore, patients taking furosemide are at risk for developing hypokalemia due to increased potassium excretion.
Correct Answer: B
Rationale: Step 1: Furosemide is a loop diuretic that works in the ascending loop of Henle to inhibit sodium and chloride reabsorption.
Step 2: Inhibition of sodium reabsorption leads to increased water and electrolyte excretion, including potassium.
Step 3: Increased potassium excretion can lead to hypokalemia, which is a common side effect of loop diuretics like furosemide.
Step 4: Hypokalemia can be dangerous, especially in patients with congestive heart failure, as it can worsen cardiac function and lead to arrhythmias.
Step 5: Therefore, patients with a history of congestive heart failure prescribed furosemide are at risk for developing hypokalemia due to increased potassium excretion.
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Which of the following cell types is primarily responsible for presenting antigens to T cells during the immune response?
- A. B cells
- B. Natural killer (NK) cells
- C. Macrophages
- D. Eosinophils
Correct Answer: C
Rationale: The correct answer is C: Macrophages. Macrophages are antigen-presenting cells that engulf pathogens and present their antigens to T cells, initiating an immune response. They express major histocompatibility complex (MHC) molecules necessary for T cell recognition. B cells also present antigens but primarily to B cells for antibody production. NK cells are involved in killing infected cells, not antigen presentation. Eosinophils are mainly involved in allergic responses and defense against parasites, not antigen presentation.
During surgery, the nurse notices that the patient's blood pressure is trending higher than the baseline. What action should the nurse take?
- A. Administer antihypertensive medication
- B. Document the blood pressure readings in the anesthesia record
- C. Notify the anesthesia provider for further assessment
- D. Continue monitoring the patient's blood pressure closely
Correct Answer: C
Rationale: The correct answer is C: Notify the anesthesia provider for further assessment. This is the most appropriate action because an anesthesia provider is trained to assess and manage changes in blood pressure during surgery. Administering antihypertensive medication (A) without proper assessment can be dangerous. Documenting the readings (B) is important but not the immediate action. Continuing to monitor closely (D) is necessary but notifying the anesthesia provider for further assessment should be the priority.
A patient receiving palliative care for end-stage renal disease is experiencing symptoms of depression. Which intervention should the palliative nurse prioritize?
- A. Encourage the patient to engage in social activities to alleviate depression.
- B. Refer the patient to a psychiatrist for pharmacological management of depression.
- C. Provide emotional support and offer counseling or therapy sessions.
- D. Explore the patient's spiritual beliefs and offer spiritual care interventions.
Correct Answer: C
Rationale: The correct answer is C because providing emotional support and offering counseling or therapy sessions address the root cause of the patient's depression in a holistic manner. This intervention allows the patient to express their emotions, process their feelings, and receive guidance on coping strategies. Encouraging social activities (A) may not directly address the underlying emotional issues. Referring to a psychiatrist for medication (B) should be considered if counseling alone is insufficient. Exploring spiritual beliefs (D) is important but may not be the most immediate priority for addressing depression in this context.
The physician prescribes decongestant intranasal spray. The nurse instructs the client on the proper use of the spray. Which of the following procedures is the CORRECT method?
- A. Finish instillation of spray into one nostril before spraying into the other nostril
- B. Inhale quickly to prevent irritation off the mucous membranes
- C. Blow the nose after spraying to prevent medications from entering the throat
- D. Tilt the head slightly forward and angle the bottle toward the side of the nostril
Correct Answer: D
Rationale: The correct answer is D: Tilt the head slightly forward and angle the bottle toward the side of the nostril. This method allows for proper administration of the spray into the nasal passage, ensuring effective delivery of the medication. Tilted head helps direct the spray towards the nasal cavity without causing discomfort or leakage. It also helps prevent the medication from dripping down the back of the throat.
Choices A, B, and C are incorrect:
A: Finishing instillation in one nostril before moving to the other can lead to uneven distribution of medication and reduced effectiveness.
B: Inhaling quickly may cause irritation and discomfort to the mucous membranes due to the forceful intake of the spray.
C: Blowing the nose after spraying can expel the medication before it has a chance to be absorbed, decreasing its efficacy.
A pregnant woman presents with fever, chills, and abdominal pain localized to the right upper quadrant. On examination, she has tenderness in the right upper abdomen and a positive Murphy's sign. Which of the following conditions is the most likely cause of these symptoms?
- A. Ectopic pregnancy
- B. Pelvic inflammatory disease
- C. Acute cholecystitis
- D. Ovarian torsion
Correct Answer: C
Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.