The LPN is caring for a patient in the preoperative period who, even after verbalizing concerns and having questions answered, states, “I know I am not going to wake up after surgery.” Which of the following actions should the nurse take?

Correct Answer: C

Rationale: The correct answer is C: Inform the registered nurse. This is the best course of action as the LPN should escalate the situation to a higher level of care by involving the registered nurse who can further assess the patient's concerns and provide appropriate interventions. A. Reassuring the patient may not address the underlying fear and may not be sufficient to alleviate their anxiety. B. Providing statistics about surgery death rates may further escalate the patient's fears and anxiety, causing more harm than good. D. Involving the family to comfort the patient may not address the patient's specific concerns and may not be within the family's scope of understanding or expertise to effectively address the situation. Informing the registered nurse allows for a more comprehensive assessment and appropriate intervention to address the patient's fears and concerns in a holistic manner.

Correct Answer: A

Rationale: The correct answer is A: Urine output increased. Furosemide is a loop diuretic that works by increasing urine output, thus helping to reduce fluid volume in the body. This effect is crucial in managing conditions like heart failure and edema. Increased urine output indicates that the medication is working as intended. Choice B: Heart rate increased is incorrect as furosemide does not directly affect heart rate. Choice C: Serum potassium decreased is incorrect as furosemide can lead to potassium loss, but this is not the primary indicator of its effectiveness. Choice D: Pulse pressure increased is incorrect as furosemide does not typically impact pulse pressure.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor. 2. ACE inhibitors like enalapril maleate block the conversion of angiotensin I to angiotensin II. 3. By inhibiting the formation of angiotensin II, enalapril maleate decreases the levels of angiotensin II. 4. Angiotensin II is a potent vasoconstrictor, so decreasing its levels leads to vasodilation and decreased blood pressure. Summary of why other choices are incorrect: - Choice B: Enalapril maleate primarily dilates arterioles by decreasing angiotensin II levels, not veins. - Choice C: Enalapril maleate does not directly adjust extracellular volume; it primarily affects the renin-angiotensin-aldosterone system. - Choice D: Enalapril maleate

Correct Answer: A

Rationale: The correct answer is A: Increased ICP. Decreasing level of consciousness is a classic sign of increased intracranial pressure (ICP) due to the compression of the brain. As ICP rises, it impairs cerebral perfusion leading to altered mental status. Parasympathetic response (B) and sympathetic response (C) are related to autonomic nervous system functions, not consciousness. Increased cerebral blood flow (D) might lead to conditions like hyperemia but does not directly cause a decreased level of consciousness.

Correct Answer: C

Rationale: The correct answer is C: Call the physician. In this scenario, the sudden severe headache and nasal congestion along with flushed skin and goosebumps suggest autonomic dysreflexia, a medical emergency in spinal cord injury at or above T6. The nurse should immediately call the physician to address this potentially life-threatening situation. Raising the client's head (A) may worsen the condition, placing the client on a firm mattress (B) is not a priority, and administering an analgesic (D) without addressing the underlying cause could lead to further complications. The priority is to identify and address the cause of autonomic dysreflexia promptly.