Nokea
A patient with a history of heart failure is prescribed lisinopril for blood pressure management. Which adverse effect is most commonly associated with lisinopril therapy?
- A. Hyperkalemia
- B. Hypertension
- C. Dry cough
- D. Bradycardia
Correct Answer: C
Rationale: Dry cough is the most commonly reported adverse effect associated with lisinopril therapy. Lisinopril is an ACE inhibitor, and the mechanism behind the cough is not completely understood but is thought to be related to the accumulation of bradykinin and substance P. This annoying dry cough can be a persistent issue for some patients on lisinopril, and it typically resolves once the medication is discontinued. Patients who experience this side effect should not ignore it and should consult their healthcare provider for further evaluation and possible alternative medication options. Hyperkalemia, hypertension, and bradycardia are not commonly associated adverse effects of lisinopril therapy.
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A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin therapy. Which laboratory test is used to monitor the therapeutic effect of warfarin?
- A. Activated partial thromboplastin time (aPTT)
- B. International normalized ratio (INR)
- C. Platelet count
- D. D-dimer
Correct Answer: B
Rationale: The laboratory test used to monitor the therapeutic effect of warfarin therapy is the International Normalized Ratio (INR). Warfarin is a commonly prescribed anticoagulant medication that works by inhibiting the action of vitamin K-dependent clotting factors. Maintaining the INR within the target range specific to the indication for anticoagulation (e.g., DVT prevention or treatment) is essential to balance the risk of bleeding and clotting.
Which additional finding confirms the diagnosis that the patient has mastitis?
- A. Enlarged glands in the axilla
- B. Normal temperature
- C. Engorged both breasts
- D. Hard mass and reddened area
Correct Answer: D
Rationale: A hard mass and a reddened area on one breast are key clinical signs that confirm the diagnosis of mastitis. Mastitis is an infection of the breast tissue that often presents with localized redness, warmth, and swelling of the breast. The presence of a hard mass along with the other symptoms suggests inflammation and infection within the breast tissue. In contrast, the other findings such as enlarged glands in the axilla, normal temperature, and engorged breasts are not specific findings for mastitis and may be present in other conditions. Therefore, the presence of a hard mass and reddened area on one breast is the additional finding that strongly confirms the diagnosis of mastitis in this case.
Which nursing diagnosis is NOT RELEVANT to sexual health?
- A. Anxiety-related inability to conceive after six months .
- B. Health-seeking behaviors related to reproductive functioning
- C. Sexual dysfunction related to an unknown cause.
- D. Risk for infection related to high-risk. sexual behaviors.
Correct Answer: B
Rationale: In the given situation, the nursing diagnosis that is NOT RELEVANT to sexual health is option B, Health-seeking behaviors related to reproductive functioning. This diagnosis focuses on the patient's proactive approach to seeking healthcare services related to reproductive health matters. However, in the situation presented of a pregnant patient with sickle cell anemia experiencing fever, painful swelling, and in labor pain, the immediate priority lies in addressing the health issues related to sickle cell disease and the current pregnancy. Sexual health is not the primary concern in this scenario compared to managing the complications of sickle cell anemia during pregnancy. Therefore, the diagnosis related to health-seeking behaviors related to reproductive functioning is not as pertinent in this specific case.
Which intervention should the nurse use to promote rest?
- A. Develop a routine with the patient to balance her studies and her rest needs .
- B. Include a significant other in helping the patient understand the need for. rest.
- C. Instruct the patient that the: baby 's health is more important than her studies at this time,
- D. Ask her why she is not complying with the prescription of bed rest.
Correct Answer: A
Rationale: Developing a routine with the patient to balance her studies and rest needs is the most appropriate intervention to promote rest. This approach considers the patient's responsibilities and can help her organize her time effectively to ensure she gets adequate rest while managing her studies. It acknowledges the importance of rest without completely disregarding the patient's other commitments, ultimately fostering a balanced approach to self-care. This intervention is patient-centered and collaborative, empowering the patient to take an active role in prioritizing rest alongside her educational responsibilities.
Which nursing intervention constitutes false imprisonment?
- A. A client is hospitalized as an involuntary admission and attempts to leave the unit. The nurse calls the security team per hospital protocol. They prevent the client from leaving.
- B. A psychotic client is admitted as an involuntary client and runs out of the psychiatric unit. The nurse runs after the client and succeeds in talking the client into returning to the unit.
- C. The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day.
- D. The client is confused, combative, and insists that no one can stop him from leaving. The nurse restrains the client without a physician's order, then seeks the order.
Correct Answer: D
Rationale: False imprisonment occurs when a client is physically restrained or confined without legal justification. In this scenario, the nurse restraining the confused and combative client without a physician's order constitutes false imprisonment. Restraints should only be used when necessary to ensure the safety of the client or others, and a physician's order is required to authorize their use. In this case, the nurse acted without proper authorization, making it a violation of the client's rights and false imprisonment. It is essential to follow proper protocols and obtain necessary orders before restraining a client.