A patient with a history of chronic liver disease presents with jaundice, ascites, and spider angiomas. Laboratory tests reveal elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia. Which condition is the patient most likely experiencing?

Correct Answer: C

Rationale: The patient's presentation of jaundice, ascites, spider angiomas, elevated serum bilirubin levels, prolonged prothrombin time, and hypoalbuminemia are all indicative of cirrhosis. Cirrhosis is a late stage of liver disease characterized by liver scarring and poor liver function. Jaundice, which is the yellowing of the skin and eyes due to elevated bilirubin levels, is a common manifestation of liver dysfunction seen in cirrhosis. Ascites, the accumulation of fluid in the abdomen, is also a common complication of cirrhosis. Spider angiomas, which are small blood vessels near the skin's surface, are a result of altered blood flow in the liver due to cirrhosis. Prolonged prothrombin time and hypoalbuminemia are consequences of reduced liver synthesis function in cirrhosis. Hepatic encephalopathy and hepatorenal syndrome

Correct Answer: C

Rationale: The first action the nurse should take when a patient post-thyroidectomy develops signs of hypocalcemia is to assess the patient's calcium level. By assessing the patient's calcium level through laboratory testing, the nurse can confirm the presence of hypocalcemia and determine the severity of the condition. This information will guide further interventions, such as administering calcium supplements or notifying the healthcare provider for additional management. It is important to confirm the diagnosis before proceeding with treatment to ensure appropriate and safe care for the patient.

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.

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.

Correct Answer: C

Rationale: Patients prescribed proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD) should be instructed to take the medication 30 minutes before meals. This is because PPIs work best when taken on an empty stomach, allowing them to inhibit the gastric proton pump effectively and reduce acid production in anticipation of food intake. Taking the medication before meals ensures optimal absorption and effectiveness in controlling symptoms of GERD.