Foundations and Adult Health Nursing Study Guide Answers

Correct Answer: A

Rationale: The nurse should monitor serum potassium levels closely during ACE inhibitor therapy because ACE inhibitors can lead to an increase in serum potassium levels, known as hyperkalemia. ACE inhibitors block the conversion of angiotensin I to angiotensin II, which in turn decreases aldosterone secretion. Aldosterone normally acts in the kidneys to reabsorb sodium and water and excrete potassium. Therefore, when aldosterone secretion is decreased due to ACE inhibitor therapy, there can be an increase in potassium retention, potentially leading to hyperkalemia. Monitoring serum potassium levels is essential to prevent complications associated with hyperkalemia, such as cardiac arrhythmias.

Correct Answer: A

Rationale: The correct way to apply anti-scabies lotion is to cover all skin areas, not just the affected areas or red areas. Scabies is a contagious skin condition caused by mites burrowing into the skin, so applying the lotion to all skin areas helps to eliminate the mites and prevent reinfestation. It is important to follow the instructions provided by the healthcare professional for proper application and treatment of scabies.

Correct Answer: D

Rationale: Using colored pictures can help make the presentation of the plan more visually engaging and easier to understand for the audience, in this case, the nurse's intended audience. Visual aids, such as colored pictures, can effectively convey complex information in a simplified and easy-to-digest manner. This approach can enhance comprehension and retention of the presented material, making the implementation of the plan more accessible and clear to the individuals involved.

Correct Answer: C

Rationale: This type of admission is considered voluntary because the patient willingly agrees to be admitted to the hospital for treatment. The patient has signed the admission forms and consented to receive the necessary care, indicating a willingness to participate in their treatment plan. In a voluntary admission, the individual retains the right to make decisions about their treatment and can choose to leave the hospital against medical advice if they wish to do so.

Correct Answer: C

Rationale: If Jose is complaining of dyspnea despite continuous oxygen therapy, the nurse's initial intervention should be to assess the patency of the tubing delivering the oxygen. A blockage in the tubing could restrict the flow of oxygen to the patient, leading to inadequate oxygen delivery and worsening dyspnea. By ensuring the tubing is clear and functioning properly, the nurse can address a potential issue with oxygen delivery before considering other interventions like giving PRN medication or involving the physician. Re-assessing the patient would also be important after ensuring the tubing's patency to evaluate the effectiveness of the intervention.