Which organ is responsible for the extensive metabolism of acetaminophen?

Correct Answer: A

Rationale: The correct answer is A: Liver. The liver is responsible for the extensive metabolism of acetaminophen through various pathways, including glucuronidation, sulfation, and oxidation. It converts acetaminophen into less toxic metabolites for elimination. The kidneys (B) primarily filter blood and regulate fluid balance; the lungs (C) are involved in gas exchange; and the pancreas (D) produces digestive enzymes and insulin, not involved in acetaminophen metabolism. Therefore, the liver is the correct choice for this question.

Correct Answer: A

Rationale: The correct answer is A: Administer oxygen. In acute shortness of breath with COPD, oxygen therapy is crucial to improve oxygenation levels and alleviate respiratory distress. Oxygen can help reduce the workload on the lungs and heart. Antibiotics (B) are not indicated unless there is a suspected bacterial infection. Monitoring blood glucose (C) is important in diabetes management but not the priority in acute respiratory distress. Administering pain relief (D) may not address the underlying cause of the shortness of breath. Oxygen therapy directly targets the respiratory issue in COPD exacerbation, making it the most effective initial intervention.

Correct Answer: B

Rationale: The correct answer is B: Pulmonary edema. In heart failure, the heart is unable to pump effectively, leading to fluid buildup in the lungs causing pulmonary edema. This can result in symptoms such as shortness of breath, coughing, and wheezing. Monitoring for pulmonary edema is crucial in heart failure management to prevent respiratory distress and worsening heart function. Rationale: A: Hypoglycemia - While patients with heart failure may be at risk for metabolic abnormalities, hypoglycemia is not a common complication directly related to heart failure. C: Anemia - Anemia can occur in heart failure due to reduced oxygen-carrying capacity of the blood, but it is not a direct complication that requires immediate monitoring like pulmonary edema. D: Hypertension - Heart failure is characterized by a reduced ability of the heart to pump blood effectively, leading to decreased cardiac output. Therefore, hypertension is not typically a complication seen in heart failure patients.

Correct Answer: D

Rationale: The correct answer is D because the patient demonstrates orientation to person (knows their name), place (knows they are at the hospital in Victoria), and time (knows it is February of a new year – 2009). This indicates intact orientation across all three domains. Choice A is incorrect as the patient is unsure of their location and the year. Choice B is incorrect as the patient is confused about the date. Choice C is incorrect as the patient is uncertain about the date and only guesses their location.

Correct Answer: B

Rationale: The correct answer is B: Sedation. Cancer patients taking opioids commonly experience sedation due to the central nervous system depressant effects of opioids. Opioids can cause drowsiness, fatigue, and decreased alertness. Tolerance (A) is a possible issue but is not the most common complication. Addiction (C) is less common in cancer patients due to the nature of their pain management. Constipation (D) is a common side effect of opioids but is not the most common complication in cancer patients. Sedation is the most prevalent issue affecting the quality of life and daily functioning of cancer patients on opioids.

Correct Answer: A

Rationale: The correct answer is A: Neutropenia. During chemotherapy, neutropenia, a decrease in white blood cells, can occur, leading to increased risk of infections. Monitoring for neutropenia is crucial for timely intervention. Hyperkalemia (B) is not commonly associated with chemotherapy. Hypoglycemia (C) is more related to diabetes or insulin therapy. Chronic pain (D) is not a typical complication of chemotherapy. Monitoring for neutropenia allows the nurse to provide appropriate care to prevent infections and ensure the patient's safety.

Correct Answer: A

Rationale: The correct answer is A because asking "Why haven't you taken your insulin?" may put the patient on the defensive. This question can come across as accusatory or judgmental, potentially making the patient feel guilty or defensive. It may hinder open communication and lead to a breakdown in the nurse-patient relationship. Explanation of other choices: B: While the question may be an attempt to gather information, it lacks sensitivity and may not promote open dialogue. C: Involving the patient's wife without the patient's consent may breach confidentiality and undermine the patient's autonomy. D: While asking the question may reveal reasons for the behavior, it is not the best approach as it can create a barrier to effective communication.

Correct Answer: A

Rationale: The correct answer is A because it helps differentiate between orthopnea (difficulty breathing when lying down) and paroxysmal nocturnal dyspnea (sudden awakening due to difficulty breathing). By asking about worsening symptoms when lying down, the nurse can assess if the patient has orthopnea, a classic symptom of heart failure. Choices B, C, and D are incorrect because they do not specifically target the nighttime breathing difficulty associated with heart failure.

Correct Answer: C

Rationale: The correct answer is C: Jaundice. In chronic liver disease, the liver's ability to process bilirubin is impaired, leading to jaundice. This is characterized by a yellowing of the skin and eyes. Monitoring for jaundice is crucial as it indicates liver dysfunction. Hypoglycemia (A) is not a typical complication of chronic liver disease. Hyperkalemia (B) is more commonly associated with kidney dysfunction. Anemia (D) can occur in liver disease but is not as specific a complication as jaundice. Therefore, monitoring for jaundice in a patient with chronic liver disease is essential for early detection and management of liver dysfunction.