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You make a home visit to evaluate a hypertensive patient who has been taking enalapril (Vasotec) for 3 weeks. Which information indicates that you need to contact the physician about a change in the drug therapy?
- A. Patient complains of frequent urination.
- B. Patient's blood pressure is 138/86.
- C. Patient coughs often during the visit.
- D. Patient complains of occasional dizziness.
Correct Answer: C
Rationale: A persistent cough is a common side effect of ACE inhibitors like enalapril, and it may warrant a change in medication.
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What is a condition characterized by the presence of air or gas in the pleural space, leading to the collapse of the lung?
- A. Pneumothorax
- B. Pulmonary embolism
- C. Pleural effusion
- D. Atelectasis
Correct Answer: A
Rationale: The correct answer is A: Pneumothorax. Pneumothorax is the presence of air or gas in the pleural space, causing the lung to collapse. This occurs when air enters the pleural space due to trauma or a lung condition. Pulmonary embolism (B) is a blockage of the artery in the lung by a blood clot. Pleural effusion (C) is the accumulation of fluid in the pleural space. Atelectasis (D) is the collapse of a part of or entire lung due to blockage or pressure. Therefore, the correct answer is A as it specifically describes the condition of air in the pleural space causing lung collapse.
Which type of lung cancer begins in the cells lining the bronchi and bronchioles?
- A. Adenocarcinoma
- B. Small cell lung cancer
- C. Squamous cell carcinoma
- D. Mesothelioma
Correct Answer: A
Rationale: The correct answer is A: Adenocarcinoma. This type of lung cancer begins in the cells lining the bronchi and bronchioles. Adenocarcinoma is the most common type of lung cancer and often affects non-smokers. It is characterized by the growth of glandular cells in the lining of the lungs.
B: Small cell lung cancer typically originates in the bronchi, but it is characterized by small, round cells and tends to grow and spread quickly.
C: Squamous cell carcinoma starts in the squamous cells lining the airways and is associated with a history of smoking.
D: Mesothelioma is a cancer of the mesothelial cells that line the lungs, not specifically the bronchi or bronchioles. It is commonly linked to asbestos exposure.
Two months after Mr. Edwards' myocardial infarction, which goal assumes highest priority?
- A. Having his wife perform most of his activities of daily living
- B. Following a weight-reduction diet
- C. Developing a physical-conditioning program
- D. Assisting him to prepare for retirement
Correct Answer: C
Rationale: Physical conditioning promotes long-term health.
What is a condition where the lung's alveoli are permanently enlarged and damaged, leading to shortness of breath?
- A. Emphysema
- B. Bronchitis
- C. Atelectasis
- D. Pulmonary fibrosis
Correct Answer: A
Rationale: The correct answer is A: Emphysema. Emphysema is a condition where the lung's alveoli are permanently enlarged and damaged, causing shortness of breath. This occurs due to the destruction of the alveoli walls, leading to decreased surface area for oxygen exchange. This results in difficulty breathing and reduced oxygen supply to the body. Bronchitis (B) is inflammation of the bronchial tubes, not alveoli damage. Atelectasis (C) is the collapse of lung tissue, not enlargement. Pulmonary fibrosis (D) is scarring of lung tissue, not alveoli enlargement.
The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?
- A. Check the potassium level.
- B. Give Digibind as an antidote.
- C. Change the dosing of digoxin to every other day.
- D. Administer a potassium supplement to decrease digoxin toxicity.
Correct Answer: B
Rationale: The correct answer is B: Give Digibind as an antidote. Digibind is the specific antidote for severe digoxin toxicity. It works by binding to the excess digoxin in the body, preventing it from exerting its toxic effects. This action helps to rapidly reduce the digoxin levels in the body and reverse the toxicity. Checking the potassium level (choice A) is important but not the priority when the client is experiencing severe toxicity. Changing the dosing of digoxin (choice C) or administering a potassium supplement (choice D) would not address the immediate need to counteract the toxicity. The priority is to administer Digibind to quickly neutralize the digoxin and prevent further harm.