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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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The patient is shouting and cursing the nurse, the nurse slaps the patient. The nurse would be guilty of:
- A. Abuse
- B. Assault
- C. Battery
- D. Physical abuse
Correct Answer: C
Rationale: Battery is the intentional touching or use of force on another individual without their consent. In this scenario, the nurse's action of slapping the patient constitutes battery as it involves a deliberate physical contact without the patient's permission. This is different from assault, which involves the threat of harm, and abuse, which encompasses various forms of mistreatment. Ultimately, the nurse in this situation would be guilty of committing a battery by unlawfully striking the patient.
A nurse is preparing to assist with a percutaneous endoscopic gastrostomy (PEG) tube insertion for a patient requiring long-term enteral feeding. What action should the nurse prioritize to ensure procedural success?
- A. Confirming the patient's fasting status before the PEG tube insertion
- B. Positioning the patient in a supine position with the head of the bed elevated
- C. Administering prophylactic antibiotics to prevent infection
- D. Coordinating with radiology or gastroenterology for procedural guidance Dermatology
Correct Answer: D
Rationale: Coordinating with radiology or gastroenterology for procedural guidance is crucial to ensure the success of a percutaneous endoscopic gastrostomy (PEG) tube insertion. This procedure is typically performed under endoscopic guidance to ensure proper placement of the tube into the stomach through the abdominal wall. Radiology or gastroenterology professionals are trained to perform and guide the insertion procedure, making their involvement essential for a successful outcome. Additionally, their expertise helps minimize the risk of complications during and after the PEG tube placement.
A patient with suspected pulmonary embolism (PE) presents with sudden onset dyspnea, pleuritic chest pain, and hemoptysis. Which of the following diagnostic tests is most appropriate for confirming the diagnosis?
- A. Chest X-ray
- B. Electrocardiography (ECG)
- C. D-dimer assay
- D. Spiral computed tomography (CT) angiography
Correct Answer: D
Rationale: Spiral CT angiography is the most appropriate test for confirming the diagnosis of pulmonary embolism (PE) in a patient with suspected PE. It is a non-invasive imaging modality that can detect filling defects within the pulmonary vasculature indicative of a clot. This diagnostic test has high sensitivity and specificity for diagnosing PE, making it a valuable tool in the management of patients with suspected PE.
On which occasion would a nurse can be charged with negligence?
- A. Giving the patient the wrong medication.
- B. Giving competent care.
- C. Following standards of care.
- D. Communicating with another health team.
Correct Answer: A
Rationale: A nurse can be charged with negligence when they give the patient the wrong medication. Negligence in healthcare typically refers to a situation where a healthcare provider fails to provide a standard level of care, resulting in harm to the patient. Giving the wrong medication can lead to serious consequences for the patient, including adverse reactions, worsening of the condition, or even death. It is a clear violation of the duty of care that a nurse owes to their patients, and such a mistake can have legal and professional repercussions for the nurse.
A postpartum client with a history of gestational diabetes expresses concern about managing blood sugar levels while breastfeeding. What nursing intervention should be prioritized to address the client's concerns?
- A. Educating the client about the importance of balanced nutrition and frequent monitoring of blood glucose levels
- B. Recommending insulin supplementation to maintain target blood sugar levels
- C. Encouraging the client to avoid breastfeeding to prevent fluctuations in blood sugar levels
- D. Referring the client to a dietitian for a specialized postpartum meal plan
Correct Answer: A
Rationale: Educating the client about the importance of balanced nutrition and frequent monitoring of blood glucose levels should be prioritized to address the client's concerns about managing blood sugar levels while breastfeeding. This intervention helps empower the client to make informed choices about her diet and monitor her blood sugar levels effectively. By focusing on balanced nutrition and regular blood glucose monitoring, the client can better manage her blood sugar levels during the postpartum period and while breastfeeding, reducing the risk of complications associated with gestational diabetes. It also promotes overall health and well-being for both the mother and the baby.