A patient with a history of heart failure is prescribed spironolactone. Which electrolyte imbalance is the patient at risk for developing with spironolactone therapy?

Correct Answer: B

Rationale: Spironolactone is a potassium-sparing diuretic commonly used in the management of heart failure. One of the significant side effects of spironolactone is hyperkalemia, which is an elevated level of potassium in the bloodstream. Spironolactone works by blocking the action of aldosterone, a hormone that regulates potassium and sodium balance in the body. By inhibiting aldosterone, spironolactone reduces potassium excretion in the urine, leading to potential accumulation of potassium in the body.

Correct Answer: B

Rationale: When a woman in active labor experiences persistent fetal malposition, such as a transverse lie presentation, assisting the mother into a hands-and-knees position is a nursing intervention to prioritize. This position can help encourage the fetus to rotate into a more favorable position for delivery, such as a head-down position. By placing the mother in a hands-and-knees position, gravity can assist in shifting the fetus to the correct position. This intervention is non-invasive and can be effective in promoting the progress of labor and avoiding the need for more invasive interventions like instrumental delivery or cesarean section. However, if the fetus does not rotate or if there are signs of fetal distress, further interventions may be necessary.

Correct Answer: D

Rationale: The nurse should respect the patient's autonomy and collaborate on alternative treatment options. It is essential to honor the patient's cultural beliefs and preferences while also seeking to find a solution that aligns with the healthcare provider's recommendations. By working together with the patient to explore alternative treatment options that are acceptable within the patient's cultural framework, the nurse can promote patient-centered care and foster a trusting relationship with the patient.Ignoring or dismissing the patient's cultural beliefs can lead to decreased patient adherence and trust in the healthcare provider. Providing education and information to help the patient understand the treatment benefits is important, but it should be done in a way that respects the patient's autonomy and cultural perspective.

Correct Answer: B

Rationale: The client should be assisted to lie in bed on the unaffected side for a thoracentesis procedure. This position allows for better access to the pleural space for the insertion of a needle to aspirate the fluid or air. Gravity helps to separate the fluid or air, making it closer to the chest wall for easier removal. Additionally, this position reduces the risk of injury to the lung or other structures, as the needle is directed away from these vital structures. Lying on the unaffected side also helps in preventing potential complications and ensures the safety and effectiveness of the procedure.

Correct Answer: A

Rationale: Proper latch technique is the most important nursing intervention to alleviate nipple soreness in a breastfeeding client. When a baby latches on correctly, it helps prevent nipple trauma and soreness. Educating the client on how to achieve a proper latch, such as ensuring the baby's mouth covers both the nipple and areola, can significantly reduce discomfort during feedings. Improving the latch can also enhance milk transfer, leading to better breastfeeding outcomes for both the mother and baby. While lanolin cream (choice C) can provide some relief for sore nipples, addressing the root cause by correcting the latch is crucial for long-term comfort and successful breastfeeding. Using nipple shields (choice B) or encouraging the use of breast pumps (choice D) should not be the first line of intervention when addressing sore nipples, as they do not address the underlying issue of latch technique.

Correct Answer: B

Rationale: The recommended screening test for cervical cancer prevention in women aged 21 to 65 years is cytology, also known as a Pap smear. The Pap smear is a test that looks for changes in the cells of the cervix that could indicate the presence of cervical cancer or pre-cancerous conditions. This test is recommended every 3 years for women aged 21-29 years, and every 3-5 years for women aged 30-65 years, depending on the screening method used. HPV testing alone or co-testing with both cytology and HPV testing may be used in certain situations, but for most women in this age group, cytology (Pap smear) alone is the recommended screening test.

Correct Answer: B

Rationale: Enamel hypoplasia is a common oral manifestation of celiac disease characterized by defects in the enamel of the teeth. These defects can appear as horizontal or vertical grooves on the teeth. Enamel hypoplasia is caused by disruptions in the formation of enamel during tooth development, leading to thin enamel or localized pitting. It can affect the appearance and strength of the teeth, making them more prone to sensitivity and breakdown. In individuals with celiac disease, enamel hypoplasia may occur due to malabsorption of essential nutrients like calcium and vitamin D. Therefore, when observing oral manifestations such as enamel defects with grooves, it is important to consider the possibility of celiac disease as an underlying cause.

Correct Answer: B

Rationale: A cohort study design would be appropriate in this scenario. Cohort studies follow a group of individuals over a period of time to assess how their current health status, personal characteristics, and potential risk factors may contribute to the development of certain outcomes or diseases. By collecting data at different time points on the same group of individuals, cohort studies allow researchers to establish associations between exposures and outcomes, providing valuable information on causality. In this case, using a cohort study design would allow for a comprehensive examination of how various factors impact health outcomes over time.

Correct Answer: B

Rationale: After being infected with the human immunodeficiency virus (HIV), it can take an average of 8-10 years before the development of Acquired Immunodeficiency Syndrome (AIDS) if left untreated. However, AIDS can manifest sooner in some cases, typically within 2 years, especially if the person's immune system is already significantly compromised or if they have other underlying health conditions. Thus, the manifestation of AIDS can vary, but it generally occurs within a range of 2 to 10 years after initial HIV infection.