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Which of the following is a genetic disorder that causes thick, sticky mucus to build up in the lungs and digestive system, leading to severe respiratory and digestive problems?
- A. Cystic fibrosis
- B. Pulmonary fibrosis
- C. Pulmonary edema
- D. Bronchiectasis
Correct Answer: A
Rationale: The correct answer is A: Cystic fibrosis. This genetic disorder is characterized by the buildup of thick, sticky mucus in the lungs and digestive system. Step 1: Cystic fibrosis specifically mentions the thick, sticky mucus, which is a key characteristic of the disorder. Step 2: Pulmonary fibrosis is a different condition where lung tissue becomes scarred and stiff. Step 3: Pulmonary edema is the accumulation of fluid in the lungs, not mucus. Step 4: Bronchiectasis is a condition where the airways in the lungs become damaged and widened, not specifically related to thick mucus buildup.
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During a home visit to an 88-year-old patient who is taking digoxin (Lanoxin) 0.25 mg daily to help control the rate of atrial fibrillation, you obtain this assessment information. Which assessment indicates that you need to notify the physician?
- A. The patient's apical pulse is 68 and very irregular.
- B. The patient takes the digoxin with meals.
- C. The patient's vision is becoming 'fuzzy'.
- D. The patient has lung crackles that clear after coughing.
Correct Answer: C
Rationale: Visual disturbances can indicate digoxin toxicity, necessitating physician notification.
The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?
- A. Cough
- B. Hyperkalemia
- C. Hypotension
- D. Dizziness
Correct Answer: A
Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor that can cause a dry, persistent cough as a common side effect. It is important to monitor for this because it can indicate a potentially serious adverse reaction called angioedema. Hyperkalemia (B) is a possible side effect of enalapril but is typically not as urgent to monitor as cough. Hypotension (C) is a common side effect but is usually monitored during the initial dose titration. Dizziness (D) is a less common side effect and is often transient. Monitoring for cough is crucial to detect and manage any potential angioedema promptly.
The client on spironolactone (Aldactone) should avoid which type of food?
- A. Foods high in potassium
- B. Foods high in sodium
- C. Foods high in calcium
- D. Foods high in chloride
Correct Answer: A
Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Consuming foods high in potassium while on spironolactone can lead to hyperkalemia, which is an elevated level of potassium in the blood. This can result in serious health complications such as irregular heartbeats and muscle weakness. Therefore, it is crucial for clients on spironolactone to avoid foods high in potassium to prevent these adverse effects. Choices B, C, and D are incorrect because spironolactone does not specifically interact with sodium, calcium, or chloride in a way that necessitates avoiding foods high in these electrolytes.
Mrs. Payer's care plan during the acute phase following MI should include attention to such psychologic aspects as fear, stress, and hopefulness. Therapeutic goals from the time of admission must be geared to
- A. acceptance
- B. rehabilitation
- C. slowing down
- D. dependence
Correct Answer: A
Rationale: Acceptance facilitates adaptation to illness.
The client on warfarin has an INR of 5.5. What is the priority nursing action?
- A. Administer vitamin K as an antidote.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Administer fresh frozen plasma.
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K as an antidote. An INR of 5.5 indicates the client is at risk for bleeding due to excessive anticoagulation from warfarin. Administering vitamin K helps reverse the effects of warfarin and lowers the INR back to the therapeutic range. Holding the next dose of warfarin (B) is important but not the priority over administering the antidote. Increasing the dose of warfarin (C) would worsen the situation. Administering fresh frozen plasma (D) is not a standard treatment for high INR levels due to warfarin.