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?

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: 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: 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.

Correct Answer: A

Rationale: The presentation described is characteristic of acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye may appear red due to conjunctival injection, and there may be a steamy cornea due to corneal edema. The mid-dilated, non-reactive pupil is a key finding in angle-closure glaucoma, as the iris bombe (forward movement of the peripheral iris) blocks the drainage angle, leading to increased intraocular pressure. If left untreated, acute angle-closure glaucoma can result in irreversible vision loss. Immediate intervention is crucial to lower the intraocular pressure and prevent further damage to the optic nerve. Prompt referral to an ophthalmologist for definitive treatment is necessary in cases of suspected acute angle-closure glaucoma.

Correct Answer: A

Rationale: Maternal dehydration can contribute to a prolonged latent phase during labor. Dehydration can lead to reduced blood volume and electrolyte imbalances, which can result in ineffective uterine contractions. Without adequate hydration, the uterus may not contract effectively, causing irregular and infrequent contractions. It is important for the nurse to assess the woman's hydration status and encourage her to stay hydrated during labor to help regulate contractions and progress labor.

Correct Answer: D

Rationale: The most appropriate response is "Many of the health services are given free, but we people pay for them just the same through our taxes." This response acknowledges the fact that public health services are funded by taxpayers, even though they may be perceived as free by the public. It highlights the connection between government funding and the provision of health services, emphasizing that these services are not truly free but are paid for through taxes. It also addresses the misconception that these services are entirely free without any costs involved.

Correct Answer: D

Rationale: Coordinating with radiology or gastroenterology for procedural guidance is crucial to ensure the success of a percutaneous endoscopic gastrostomy (PEG) tube insertion. This procedure is typically performed under endoscopic guidance to ensure proper placement of the tube into the stomach through the abdominal wall. Radiology or gastroenterology professionals are trained to perform and guide the insertion procedure, making their involvement essential for a successful outcome. Additionally, their expertise helps minimize the risk of complications during and after the PEG tube placement.

Correct Answer: C

Rationale: The most appropriate action for a concerned nurse when nurses are projected as sex symbols in a television advertisement is to make a position paper to denounce the advertisement. This approach allows the nurse to voice their concerns in a formal and professional manner. By creating a position paper, the nurse can clearly outline why the portrayal is inappropriate and advocate for more respectful representations of nursing in the media. This action is constructive, proactive, and focuses on initiating change through advocacy and education. It is a thoughtful and strategic way to address the issue and raise awareness about the importance of respecting the nursing profession.

Correct Answer: A

Rationale: When a nurse involves well-being in her definition of health, it indicates a holistic approach that considers not only physical health but also emotional, mental, and social aspects of well-being. In the context of a family confronting the imminent death of a family member, the primary concern of the nurse would be to focus on reinforcing the need for the whole family to adapt to the impending death. This involves providing emotional support, facilitating communication, addressing coping mechanisms, and assisting the family in coming to terms with the situation. By emphasizing the importance of the whole family adapting to the imminent death, the nurse can help promote holistic well-being for the family during this challenging time.