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What clinical manifestations would the nurse expect to find in a client who is experiencing anaphylaxis?
- A. Dilated bronchioles, constriction of peripheral blood vessels, decreased capillary permeability
- B. Asthma, deep vein thrombosis, hepatic encephalopathy
- C. Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability
- D. Left-sided heart failure, pulmonary embolism, urinary tract infection
Correct Answer: C
Rationale: In anaphylaxis, the client would present with narrowing of the bronchioles, dilation of the peripheral blood vessels, and increased capillary permeability. These manifestations lead to symptoms such as difficulty breathing, low blood pressure, and swelling. Choices A, B, and D are incorrect because they do not describe the typical clinical manifestations of anaphylaxis.
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In a male patient with benign prostatic hyperplasia (BPH) prescribed tamsulosin (Flomax), what is the expected therapeutic effect of this medication?
- A. Decreased urinary frequency and urgency
- B. Increased urinary output
- C. Decreased blood pressure
- D. Increased hair growth
Correct Answer: A
Rationale: The correct answer is A: Decreased urinary frequency and urgency. Tamsulosin is prescribed for patients with BPH to relax the muscles in the prostate and bladder neck. This relaxation helps in relieving the symptoms of BPH, such as decreased urinary flow, frequent urination, and urgency. Choice B is incorrect because tamsulosin does not increase urinary output but rather improves the flow of urine by relaxing the muscles. Choice C is incorrect as tamsulosin is not primarily used for reducing blood pressure. Choice D is also incorrect as tamsulosin does not promote increased hair growth.
A nurse is caring for a client with lung cancer who is experiencing dyspnea. Which intervention is most appropriate?
- A. Administer a cough suppressant to reduce discomfort.
- B. Encourage the client to lie flat to ease breathing.
- C. Provide supplemental oxygen therapy.
- D. Encourage deep breathing and coughing exercises.
Correct Answer: C
Rationale: The most appropriate intervention for a client with lung cancer experiencing dyspnea is to provide supplemental oxygen therapy. This intervention helps improve oxygenation and alleviate breathing difficulties. Administering a cough suppressant (Choice A) may not address the underlying cause of dyspnea and can potentially depress the respiratory drive. Encouraging the client to lie flat (Choice B) can worsen dyspnea by reducing lung expansion. Encouraging deep breathing and coughing exercises (Choice D) may be beneficial in some situations, but when a client is experiencing dyspnea due to lung cancer, supplemental oxygen therapy is the priority to improve oxygen levels and alleviate breathing difficulty.
When a client has their 'fight or flight' system activated, which below is a manifestation of that?
- A. Decreased blood pressure
- B. Decreased heart rate
- C. Decreased respiration rate
- D. Increased glucose levels
Correct Answer: D
Rationale: The correct answer is D, 'Increased glucose levels.' When the 'fight or flight' system is activated, the body releases glucose to provide energy for the impending response. This increase in glucose levels helps fuel the body's reaction to the perceived threat or stressor. Choices A, B, and C are incorrect because during the 'fight or flight' response, blood pressure, heart rate, and respiration rate typically increase to prepare the body to confront or flee from the perceived danger.
What should the nurse assess in a patient experiencing breakthrough bleeding while taking oral contraceptives?
- A. Adherence to the medication schedule
- B. The possibility of pregnancy
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct Answer: A
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of non-adherence, potentially reducing the effectiveness of the contraceptives. Assessing the adherence to the schedule helps in determining if the medication is being taken correctly. The possibility of pregnancy (choice B) is less likely if the patient has been taking the contraceptives as prescribed. Increasing the dosage (choice C) without assessing adherence first can lead to unnecessary medication adjustments. Evaluating the effectiveness of the current oral contraceptive (choice D) comes after assessing adherence to the schedule.
A patient has been prescribed conjugated estrogens for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?
- A. Increase the intake of calcium-rich foods.
- B. Decrease the intake of high-fat foods.
- C. Avoid the use of tobacco.
- D. Avoid exposure to sunlight.
Correct Answer: A
Rationale: The correct answer is A: Increase the intake of calcium-rich foods. Patients taking conjugated estrogens should increase their intake of calcium-rich foods to help prevent osteoporosis. Estrogen therapy can lead to an increased risk of osteoporosis, so ensuring an adequate intake of calcium is crucial. Choices B, decreasing high-fat foods, and C, avoiding tobacco, are general health recommendations but not directly related to the prescription of conjugated estrogens. Choice D, avoiding exposure to sunlight, is not a direct concern when taking conjugated estrogens.