A patient is prescribed a calcium channel blocker for the management of hypertension. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: D

Rationale: Calcium channel blockers are often prescribed for the management of hypertension because they can help relax blood vessels and slow the heart rate, thus reducing blood pressure. One of the major adverse effects associated with calcium channel blockers is bradycardia (slow heart rate) or even more rarely, tachycardia (fast heart rate). Therefore, in a patient prescribed a calcium channel blocker for hypertension, the nurse should closely monitor for any signs and symptoms of tachycardia as it can be a serious adverse effect that needs prompt evaluation and intervention to prevent complications.

Correct Answer: B

Rationale: The priority nursing diagnosis for a patient undergoing surgery (closure of the sac) would be risk for infection. This is because surgical procedures increase the risk of infection due to the breach in the skin and introduction of microorganisms. Infection can lead to serious complications, delay healing, and prolong recovery time. Therefore, prevention, early detection, and prompt treatment of infections are essential in the perioperative period to ensure the best possible outcomes for the patient.

Correct Answer: B

Rationale: Total care nursing is a nursing care delivery model where one nurse is assigned to provide comprehensive care to a patient for an entire shift. In this case, the private duty nurse is providing holistic care to the post-caesarian patient during the shift, which aligns with the principles of total care nursing. This approach allows the nurse to focus on the individual needs of the patient and provide all aspects of care, promoting continuity and personalized attention. Total care nursing ensures that the patient receives consistent and dedicated care from the same nurse, enhancing the patient's overall experience and outcomes.

Correct Answer: A

Rationale: Crisis intervention is an important part of secondary prevention in the care of families. Secondary prevention involves activities that aim to reduce the impact of a crisis or event that has already occurred. Crisis intervention provides immediate support and strategies to help families cope with and overcome a crisis situation. By addressing the crisis quickly and effectively, secondary prevention can help prevent further negative outcomes and promote the well-being of the family members.

Correct Answer: C

Rationale: When discharging a suicidal patient who has been taking tricyclic antidepressant drugs, it is crucial for the nurse to evaluate the risk for suicide by overdose of the medication. Tricyclic antidepressants have a narrow therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose can be quite small. This makes them particularly dangerous in cases of overdose, as they can lead to severe toxic effects, including cardiac arrhythmias, seizures, and death.

Correct Answer: A

Rationale: The most appropriate intervention for managing hepatic encephalopathy in this patient receiving palliative care for end-stage liver disease is to administer lactulose or other ammonia-lowering agents to reduce ammonia levels. Hepatic encephalopathy is believed to be primarily caused by the accumulation of ammonia in the bloodstream due to compromised liver function. Lactulose works by acidifying the gut lumen, which facilitates the excretion of ammonia in the form of ammonium ions. By reducing ammonia levels, hepatic encephalopathy symptoms, such as confusion and altered mental status, can be improved. Initiating other supportive measures like managing precipitating factors, maintaining hydration, and addressing nutritional issues should also be part of the holistic approach in managing hepatic encephalopathy in palliative care. However, addressing the underlying cause by reducing ammonia levels with lactulose is the priority intervention in this scenario.

Correct Answer: A

Rationale: Magnetic Resonance Imaging (MRI) is a specialized medical imaging technique that uses magnetic fields and radio waves to create detailed images of the organs and tissues within the body. In the context of the scenario provided, an MRI is ordered by the attending physician to validate the medical impression.

Correct Answer: A

Rationale: Acute narrow-angle glaucoma is a medical emergency that requires timely intervention to reduce intraocular pressure. Acetazolamide (Diamox) is a medication commonly used to treat this condition as it works as a carbonic anhydrase inhibitor, reducing the production of aqueous humor in the eye. By reducing the production of aqueous humor, acetazolamide helps decrease intraocular pressure rapidly, which is crucial in managing acute narrow-angle glaucoma. Other options listed, such as Furosemide (Lasix), Atropine, and Urokinase (Abbokinase), are not typically used in the treatment of acute narrow-angle glaucoma.

Correct Answer: A

Rationale: ** In a patient with ARDS, the priority intervention to manage respiratory failure is to initiate lung-protective mechanical ventilation with low tidal volume. ARDS is characterized by widespread inflammation and injury to the alveoli, leading to impaired gas exchange and severe hypoxemia. Lung-protective ventilation strategies aim to minimize ventilator-induced lung injury by using lower tidal volumes (around 6 mL/kg of predicted body weight) to reduce barotrauma and volutrauma.