Nokea
Two weeks later, Mr. Cook returns with normal blood pressure readings. Your evaluation of this situation would be
- A. since his blood pressure is normal, he no longer needs medication
- B. since his blood pressure recordings are normal, he no longer needs to maintain his prescribed diet
- C. his medication needs to be adjusted
- D. the combination of weight loss and medication is effective
Correct Answer: D
Rationale: Weight loss and medication contribute to effective blood pressure control.
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The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?
- A. Dry cough
- B. Hypotension
- C. Hyperkalemia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Dry cough. Enalapril is an ACE inhibitor, which commonly causes a dry cough due to increased bradykinin levels. This side effect is well-documented in literature and can lead to medication non-adherence. Other choices (B) Hypotension, (C) Hyperkalemia, and (D) Headache are potential side effects of enalapril but are not as commonly associated as dry cough. Hypotension and hyperkalemia are more serious adverse effects that require monitoring, while headache is a less common side effect compared to dry cough.
Which of the following veins is the largest and carries back deoxygenated blood from the tissues in the lower extremities and enters the heart proximally?
- A. Pulmonary artery
- B. Inferior vena cava
- C. Pulmonary vein
- D. Superior vena cava
Correct Answer: B
Rationale: The inferior vena cava is the largest vein carrying deoxygenated blood from the lower body into the heart.
The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?
- A. Administer vitamin K.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Monitor the client's INR closely.
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K. When a client on warfarin has an INR of 4.5, it indicates over-anticoagulation, putting them at risk of bleeding. Vitamin K helps reverse the effects of warfarin by promoting clotting factors. Administering vitamin K will lower the INR back into the therapeutic range. Holding the next dose of warfarin (B) is not enough to rapidly reverse the effects. Increasing the dose of warfarin (C) would worsen the over-anticoagulation. Monitoring the INR closely (D) is important but not the immediate action needed for a high INR.
This is a type of therapy that involves removing fluid from the lungs, typically through the use of diuretics.
- A. Diuretic therapy
- B. Oxygen therapy
- C. Inhaler therapy
- D. Antihistamine therapy
Correct Answer: A
Rationale: The correct answer is A: Diuretic therapy. This is because diuretics are medications used to remove excess fluid from the body, including the lungs. By increasing urine output, diuretics help reduce fluid buildup in the lungs, making it easier to breathe. Oxygen therapy (B) delivers oxygen to the lungs but does not involve removing fluid. Inhaler therapy (C) is used for respiratory conditions like asthma but does not remove fluid from the lungs. Antihistamine therapy (D) is used to treat allergies and does not address fluid buildup in the lungs. Thus, diuretic therapy is the most appropriate choice for removing fluid from the lungs.
What procedure involves inserting a needle into the pleural space to remove excess fluid and help the patient breathe more easily?
- A. Thoracentesis
- B. Bronchoscopy
- C. Spirometry
- D. Arterial blood gas (ABG)
Correct Answer: A
Rationale: The correct answer is A: Thoracentesis. This procedure involves inserting a needle into the pleural space to drain excess fluid, which can accumulate due to conditions like pleural effusion or pneumonia, helping the patient breathe easier. It's performed under ultrasound guidance, ensuring precise fluid removal without damaging nearby structures. Thoracentesis is a diagnostic and therapeutic procedure, providing fluid for analysis and relieving symptoms of dyspnea.
Summary:
B: Bronchoscopy is a procedure to visualize the airways using a thin, flexible tube and is not used for draining pleural fluid.
C: Spirometry is a lung function test measuring airflow and is not a procedure for removing pleural fluid.
D: Arterial blood gas (ABG) is a blood test to assess oxygen and carbon dioxide levels in the blood and is not related to removing pleural fluid.