Nokea
The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
- A. It decreases levels of angiotensin II
- B. It dilates the arterioles and veins
- C. It adjusts the extracellular volume
- D. It decreases cardiac output
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor.
2. ACE inhibitors like enalapril maleate block the conversion of angiotensin I to angiotensin II.
3. By inhibiting the formation of angiotensin II, enalapril maleate decreases the levels of angiotensin II.
4. Angiotensin II is a potent vasoconstrictor, so decreasing its levels leads to vasodilation and decreased blood pressure.
Summary of why other choices are incorrect:
- Choice B: Enalapril maleate primarily dilates arterioles by decreasing angiotensin II levels, not veins.
- Choice C: Enalapril maleate does not directly adjust extracellular volume; it primarily affects the renin-angiotensin-aldosterone system.
- Choice D: Enalapril maleate
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The LPN is caring for a patient in the preoperative period who, even after verbalizing concerns and having questions answered, states, “I know I am not going to wake up after surgery.” Which of the following actions should the nurse take?
- A. Reassure patient everything will be all right
- B. Explain national surgery death rate
- C. Inform the registered nurse
- D. Ask family to comfort the patient
Correct Answer: C
Rationale: The correct answer is C: Inform the registered nurse. This is the best course of action as the LPN should escalate the situation to a higher level of care by involving the registered nurse who can further assess the patient's concerns and provide appropriate interventions.
A. Reassuring the patient may not address the underlying fear and may not be sufficient to alleviate their anxiety.
B. Providing statistics about surgery death rates may further escalate the patient's fears and anxiety, causing more harm than good.
D. Involving the family to comfort the patient may not address the patient's specific concerns and may not be within the family's scope of understanding or expertise to effectively address the situation.
Informing the registered nurse allows for a more comprehensive assessment and appropriate intervention to address the patient's fears and concerns in a holistic manner.
During a routine checkup, the nurse assesses a client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the common AIDS-related cancer?
- A. Squamous cell carcinoma
- B. Leukemia
- C. Multiple myeloma
- D. Kaposi’s sarcoma
Correct Answer: D
Rationale: The correct answer is D: Kaposi’s sarcoma. This is a common AIDS-related cancer caused by Human Herpesvirus 8 (HHV-8) in immunosuppressed individuals. It presents as purplish lesions on the skin and mucous membranes. Squamous cell carcinoma (A) is not specific to AIDS. Leukemia (B) and Multiple myeloma (C) are not commonly associated with AIDS. Kaposi’s sarcoma is the hallmark cancer seen in AIDS patients due to their weakened immune system.
A client with spinal cord injury at the level of T3 complains of a sudden severe headache and nasal congestion. The nurse observes that the client has a flushed skin with goose bumps. Which of the ff actions should the nurse first take?
- A. Raise the client’s head
- B. Place the client on a firm mattress
- C. Call the physician
- D. Administer an analgesic to relieve the pain
Correct Answer: C
Rationale: The correct answer is C: Call the physician. In this scenario, the sudden severe headache and nasal congestion along with flushed skin and goosebumps suggest autonomic dysreflexia, a medical emergency in spinal cord injury at or above T6. The nurse should immediately call the physician to address this potentially life-threatening situation. Raising the client's head (A) may worsen the condition, placing the client on a firm mattress (B) is not a priority, and administering an analgesic (D) without addressing the underlying cause could lead to further complications. The priority is to identify and address the cause of autonomic dysreflexia promptly.
Which of the ff. would the nurse explain to the patient is the triad of symptoms associated with Meniere’s disease?
- A. Hearing loss, vertigo, and tinnitus
- B. Nausea, vomiting and pain
- C. Nystagmus, headache and vomiting
- D. Nystagmus, vomiting and pain
Correct Answer: A
Rationale: The correct answer is A: Hearing loss, vertigo, and tinnitus. Meniere's disease is characterized by a triad of symptoms: recurrent episodes of vertigo, sensorineural hearing loss, and tinnitus. Vertigo is a spinning sensation, hearing loss affects the inner ear, and tinnitus is ringing in the ear. Nausea, vomiting, pain, nystagmus, or headache are not typically part of the classic triad of Meniere's disease symptoms. Therefore, option A is the most appropriate choice based on the specific symptomatology associated with Meniere's disease.
A client with suspected lymphoma is scheduled for lymphangiography. The nurse should inform the client that this procedure may cause which harmless, temporary change?
- A. Purplish stools
- B. Redness of the upper part of the feet
- C. Bluish urine
- D. Coldness of the soles
Correct Answer: B
Rationale: The correct answer is B: Redness of the upper part of the feet. During lymphangiography, a contrast dye is injected into the lymphatic vessels. This may cause temporary redness in the upper part of the feet due to the dye spreading throughout the lymphatic system. Purplish stools (A), bluish urine (C), and coldness of the soles (D) are not expected side effects of lymphangiography and do not have a direct correlation with the procedure.