A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor for heart failure. Which laboratory parameter should the nurse monitor closely during ACE inhibitor therapy?

Correct Answer: A

Rationale: The nurse should monitor serum potassium levels closely during ACE inhibitor therapy because ACE inhibitors can lead to an increase in serum potassium levels, known as hyperkalemia. ACE inhibitors block the conversion of angiotensin I to angiotensin II, which in turn decreases aldosterone secretion. Aldosterone normally acts in the kidneys to reabsorb sodium and water and excrete potassium. Therefore, when aldosterone secretion is decreased due to ACE inhibitor therapy, there can be an increase in potassium retention, potentially leading to hyperkalemia. Monitoring serum potassium levels is essential to prevent complications associated with hyperkalemia, such as cardiac arrhythmias.

Correct Answer: D

Rationale: The Patient's Bill of Rights typically focuses on ensuring patients have the right to certain aspects of their healthcare, such as the right to refuse treatment, the right to informed consent, and the right to receive treatment. Civil commitment, on the other hand, refers to the legal process through which an individual is involuntarily placed in a psychiatric facility for evaluation and treatment. This issue is not typically addressed in the Patient's Bill of Rights, as it involves specific legal procedures rather than general patient rights.

Correct Answer: B

Rationale: The constellation of severe lower abdominal pain, fever, and vaginal discharge in a pregnant woman raises suspicion for pelvic inflammatory disease (PID). Cervical motion tenderness and adnexal tenderness are classic physical exam findings for PID. The presence of bilateral adnexal masses further supports the diagnosis, as PID can lead to the formation of tubo-ovarian abscesses. Ectopic pregnancy may present with similar symptoms but is less likely in this case as bilateral adnexal masses suggest a more diffuse inflammatory process. Placenta previa would typically present with painless vaginal bleeding in the third trimester, which is not consistent with the symptoms described. Ovarian torsion would present with sudden severe unilateral lower abdominal pain and is less likely to involve both ovaries simultaneously.

Correct Answer: C

Rationale: Colposcopy with biopsy is the most appropriate diagnostic test for evaluating a woman with suspected cervical dysplasia. Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to examine the cervix for any abnormal areas. If abnormal tissue is identified during colposcopy, a biopsy will be taken to confirm the presence of cervical dysplasia and determine the severity. This allows for a more accurate diagnosis and appropriate management of the condition. Pap smear, although a screening test for cervical dysplasia, may not provide a definitive diagnosis and may require further evaluation with colposcopy and biopsy. Endometrial biopsy and transvaginal ultrasound are not indicated for evaluating cervical dysplasia specifically.

Correct Answer: A

Rationale: When a patient is receiving too much insulin, the most likely result is hypoglycemia, not hyperglycemia. The excess insulin causes the blood glucose level to drop too low, leading to symptoms such as sweating, tremors, confusion, and in severe cases, seizures. The body responds to hypoglycemia by releasing counterregulatory hormones such as glucagon, epinephrine, and cortisol, which work to increase the blood glucose level. This rebound effect, known as the Somogyi effect, can result in the patient experiencing high blood glucose levels after a period of insufficient glucose supply due to excessive insulin administration.

Correct Answer: A

Rationale: Participating in professional organizations can provide Nurse Bea with numerous opportunities to network with other professionals in the field, stay updated with the latest trends and developments in nursing, access resources for professional growth, and even participate in leadership roles within the organization. Being active in a professional organization can help Nurse Bea build her professional profile, gain recognition, and open up possibilities for career advancement and opportunities for collaboration and learning from peers. It can also help her stay connected with the broader nursing community and enhance her visibility within the field. Engaging with a professional organization is a valuable way for Nurse Bea to enhance her career alongside pursuing further education.

Correct Answer: B

Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.

Correct Answer: C

Rationale: Bone pain in the back of the ribs is a classic manifestation of multiple myeloma. Multiple myeloma is a type of cancer that primarily affects plasma cells in the bone marrow, leading to weakened bones and bone pain. Patients with multiple myeloma often experience bone pain in areas such as the ribs, spine, and pelvis. The bone pain is typically persistent and worsens with movement or pressure. Additionally, other common symptoms of multiple myeloma include anemia, kidney damage, recurrent infections, and elevated calcium levels in the blood.

Correct Answer: D

Rationale: Pelvic ultrasound can detect fetal congenital defects, placenta previa, and fetal lung maturity.