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Which of the following laboratory findings is most consistent with acute respiratory distress syndrome (ARDS)?
- A. Elevated serum bicarbonate (HCO3-) level
- B. Decreased serum albumin level
- C. Elevated white blood cell count (WBC)
- D. Increased lactate dehydrogenase (LDH) level
Correct Answer: D
Rationale: Acute respiratory distress syndrome (ARDS) is a severe condition characterized by widespread inflammation in the lungs leading to increased pulmonary vascular permeability, non-cardiogenic pulmonary edema, and respiratory failure. In ARDS, the alveolar-capillary barrier is disrupted, resulting in fluid accumulation in the alveoli and impaired gas exchange.
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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.
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.
What is the appropriate ratio of chest compressions to rescue breaths for adult CPR?
- A. 15 compressions: 2 breaths
- B. 30 compressions: 2 breaths
- C. 30 compressions: 1 breath
- D. 15 compressions: 1 breath
Correct Answer: C
Rationale: The appropriate ratio of chest compressions to rescue breaths for adult CPR is 30 compressions to 2 breaths. This means that after every 30 chest compressions, two rescue breaths should be given. This ratio helps in maintaining oxygen circulation in the body while also ensuring that the heart is being effectively pumped to circulate blood. The emphasis on chest compressions is critical in maintaining blood flow to vital organs during cardiac arrest, while the rescue breaths help in providing oxygen to the patient's lungs. This ratio is recommended by organizations like the American Heart Association for performing high-quality adult CPR.
A patient with a history of heart failure is prescribed digoxin. Which assessment finding indicates a potential adverse effect of digoxin therapy?
- A. Bradycardia
- B. Hypotension
- C. Hyperkalemia
- D. Confusion
Correct Answer: D
Rationale: Confusion is a potential adverse effect of digoxin therapy. Digoxin toxicity can manifest as various central nervous system symptoms, including confusion, delirium, and disorientation. It is important to monitor for signs of digoxin toxicity in patients taking this medication, especially those with a history of heart failure or renal impairment. Other common signs of digoxin toxicity may include visual disturbances (like halos around lights), gastrointestinal symptoms (like nausea and vomiting), and cardiac arrhythmias. Monitoring serum digoxin levels can help guide therapy and identify toxicity early.
The nurse is developing a plan of care for the client with multiple myeloma. The nurse includes which priority intervention in the plan of care?
- A. Encourage fluid
- B. Coughing and deep breathing
- C. Providing frequent oral care
- D. Monitoring red blood cell coun
Correct Answer: B
Rationale: A priority intervention for a client with multiple myeloma is to include coughing and deep breathing exercises in the plan of care. Multiple myeloma can affect the bone marrow's ability to produce healthy blood cells, including red blood cells, which can lead to anemia. Anemia can cause fatigue and shortness of breath. By encouraging coughing and deep breathing exercises, the nurse can help improve lung function, enhance oxygenation, and prevent potential respiratory complications in the client with multiple myeloma. This intervention is crucial in promoting respiratory health and overall well-being for the client.