Question

A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

Answer 1

Correct Answers:

Take this medication with meals.
Do not take this medication with oral antacids.
This medication can cause dysrhythmias and pneumonia.

Rationale :

🧪Cimetidine is an H2 receptor antagonist that is usually taken with meals to help reduce and control gastric acid secretion during digestion.

💊Taking cimetidine together with antacids can reduce its absorption, so clients are taught to separate antacids and cimetidine by at least 1–2 hours.

❤️Cimetidine, especially when given IV, has been associated with cardiac dysrhythmias, so patients should be monitored for cardiac side effects.

🫁Long-term suppression of stomach acid may increase the risk of respiratory infections like pneumonia, because reduced acidity allows more bacterial overgrowth that can be aspirated.

📌Core Message

Cimetidine is an H2 blocker taken with meals, should not be combined closely with antacids, and can rarely cause serious cardiac and respiratory complications like dysrhythmias and pneumonia.

Answer 2

Correct Answers:

Furosemide (Lasix) IV

Rationale :

🫀In cardiogenic shock with an increased PAWP and low cardiac output, the main problem is fluid overload and poor pumping ability of the heart.

💧An elevated pulmonary artery wedge pressure indicates excess volume and high filling pressures that worsen pulmonary congestion and dyspnea.

💊Furosemide is a loop diuretic that reduces intravascular volume, thereby decreasing preload and helping relieve pulmonary edema in cardiogenic shock.

📉By decreasing fluid volume, IV furosemide can improve symptoms of congestion and facilitate better cardiac performance without adding more volume or excessive vasoconstriction.

📌Core Message

In cardiogenic shock with high PAWP and fluid overload, IV furosemide is appropriate to reduce preload and relieve pulmonary congestion.

Answer 3

Correct Answers:

sardines and liver.

Rationale :

🧬Uric acid calculi are associated with high intake of purines, which are metabolized into uric acid and can crystallize in the urinary tract.

🥩Foods such as sardines and liver are classic examples of purine-rich organ meats and oily fish, making them important to limit in patients with uric acid stones.

🪨Reducing purine intake helps decrease uric acid levels in the blood and urine, lowering the risk of stone formation and recurrence.

📚Patient teaching for uric acid stones focuses on dietary modification, specifically limiting organ meats, certain fish, and other high-purine foods as part of long-term prevention.

📌Core Message

To prevent uric acid renal calculi, patients should limit high-purine foods like sardines and liver to reduce uric acid levels and stone recurrence.

Answer 4

Correct Answers:

blood potassium level of 2.8 mEq/L

Rationale :

💊Furosemide is a potent loop diuretic that increases urinary excretion of potassium, putting patients at risk for hypokalemia.

⚠️A potassium level of 2.8 mEq/L is significantly low and can lead to life-threatening cardiac dysrhythmias, making it an immediate priority.

📉Early recognition of electrolyte disturbances is critical because cardiac and neuromuscular complications can develop rapidly at this potassium level.

🫀While elevated blood pressure or mild orthostatic changes are concerning, a dangerously low potassium level requires the fastest intervention to prevent arrhythmias and cardiac arrest.

📌Core Message

With furosemide therapy, a serum potassium of 2.8 mEq/L is an urgent finding due to the risk of fatal dysrhythmias, making it the top priority.

Answer 5

Correct Answers:

"Do you find it difficult to control your worrying?"

Rationale :

🧠Generalized anxiety disorder is characterized by excessive anxiety and worry occurring more days than not for at least 6 months about a number of events or activities.

🗣A key diagnostic feature is that the person finds it difficult to control the worrying, making this question directly assess the core symptom.

📋Other symptoms of generalized anxiety disorder, such as restlessness, fatigue, and sleep disturbance, are important, but the inability to control worry is central to diagnosis.

📚Asking specifically about control of worry helps distinguish generalized anxiety disorder from other conditions like social anxiety, OCD, or PTSD, which have different hallmark features.

📌Core Message

For generalized anxiety disorder, assessing whether the client can control their worrying directly targets the core diagnostic feature of the disorder.

Answer 6

Correct Answers:

Angioedema and pruritis
Chest tightness and wheezing
Hypotension and tachycardia
Nausea and stomach cramps

Rationale :

😰Anaphylactic shock is a severe systemic allergic reaction that commonly involves the skin, respiratory, cardiovascular, and gastrointestinal systems all at once.

🩹Angioedema and pruritis indicate significant cutaneous involvement, with rapid swelling and intense itching that are classic early signs of a generalized allergic reaction.

🫁Chest tightness and wheezing show bronchospasm and airway narrowing, which are hallmark respiratory manifestations that can quickly lead to airway obstruction if not treated.

🩺Hypotension and tachycardia reflect profound vasodilation and capillary permeability, leading to distributive shock, while nausea and stomach cramps demonstrate GI tract involvement as part of the systemic response.

📌Core Message

Anaphylactic shock is a multi-system allergic emergency typically presenting with skin changes, bronchospasm, hypotension with tachycardia, and sometimes GI symptoms, all indicating a severe systemic hypersensitivity reaction.

Answer 7

Correct Answers:

Oxygen saturation

Rationale :

🫁In anaphylactic shock, the most critical life threat is airway compromise and impaired gas exchange, so monitoring oxygenation is paramount.

📈Oxygen saturation directly reflects how well oxygen is being delivered to the blood, making it the best measure of treatment effectiveness in this context.

🧯Therapies such as epinephrine, oxygen, and airway support aim primarily to improve ventilation and perfusion, which will be evident in improved saturation.

🏥Although blood pressure, heart rate, and orientation are important, the primary priority in anaphylaxis is airway and breathing, making oxygen saturation the most important parameter.

📌Core Message

When evaluating treatment for anaphylactic shock, oxygen saturation is the most important indicator because it reflects improvement in airway and breathing.

Answer 8

Correct Answers:

Respiratory Acidosis, partially compensated

Rationale :

🩺A pH of 7.32 indicates acidemia, meaning the blood is more acidic than normal.

🫁A PaCO₂ of 48 mm Hg is elevated, indicating that the primary problem is hypoventilation leading to CO₂ retention, which defines respiratory acidosis.

🧪The HCO₃ of 30 mEq/L is higher than normal, showing that the kidneys are retaining bicarbonate to buffer the acid and partially compensate for the respiratory problem.

📊Because the pH is still abnormal but the bicarbonate is elevated, this pattern is described as partially compensated respiratory acidosis, not fully compensated or a metabolic disorder.

📌Core Message

The ABG pattern of low pH, high PaCO₂, and high HCO₃⁻ indicates partially compensated respiratory acidosis due to CO₂ retention with renal compensation.

Answer 9

Correct Answers:

Dish of lemon gelatin

Rationale :

🥣After nausea and vomiting, oral intake should restart with clear liquids and easily digestible, non-irritating foods.

🟡A dish of lemon gelatin is a clear, non-acidic, low-residue option that is gentle on the GI tract and well-tolerated.

🔥Hot chicken broth may be too stimulating and salty, orange juice is acidic, and coffee with cream contains caffeine and fat, all of which can worsen gastric irritation.

📚Using clear, bland fluids like gelatin helps assess tolerance and decreases the risk of recurrent nausea and vomiting.

📌Core Message

After being NPO for nausea and vomiting, the safest restart is a clear, bland item like lemon gelatin to minimize GI irritation and test tolerance.

Answer 10

Correct Answers:

Stabilization of the patient

Rationale :

😨In an acute crisis situation with severe anxiety and hysteria, the immediate priority is to achieve stabilization, not long-term outcomes like total recovery.

🧠Severe anxiety can impair judgment, safety, and coping, so the first goal is to decrease arousal to a level where the patient can think and respond more clearly.

🛟Stabilization includes ensuring safety, reducing overwhelming emotional distress, and helping the patient regain basic emotional and physiological control.

📅Goals such as optimal wellness, remission, or complete recovery are important but are long-term treatment outcomes that follow initial crisis stabilization.

📌Core Message

In an acute crisis with severe anxiety, the first nursing goal is stabilization, ensuring safety and reducing overwhelming distress before working on long-term recovery.

1 :
A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

2 :
A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128, respirations 28. The pulmonary artery wedge pressure (PAWP) is increased and cardiac output is low. The nurse will anticipate an order for which medication?

3 :
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to limit foods high in purines. Which of the following foods should be limited?

4 :
The nurse is evaluating the response to treatment for a patient that has recently started taking furosemide to treat stage 2 hypertension. Which clinical findings will require the nurse to act most rapidly?

5 :
A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?

6 :
The emergency department nurse is caring for a patient with a suspected anaphylactic reaction to peanuts. What are the 4 (four) possible clinical manifestations of anaphylactic shock? Select the four correct answers.

7 :
Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective?

8 :
A patient on the Med-Surg floor who recently had abdominal surgery is now complaining of dizziness, shortness of breath, headache and a racing heart. How should the nurse interpret the following arterial blood gas results: pH 7.32, PaO2 87 mm Hg, PaCO2 48 mm Hg, and HCO3 30 mEq/L?

9 :
Which item should the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?

10 :
A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening. What is the most immediate nursing goal for this patient?

1 : A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

2 : A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128, respirations 28. The pulmonary artery wedge pressure (PAWP) is increased and cardiac output is low. The nurse will anticipate an order for which medication?

3 : To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to limit foods high in purines. Which of the following foods should be limited?

4 : The nurse is evaluating the response to treatment for a patient that has recently started taking furosemide to treat stage 2 hypertension. Which clinical findings will require the nurse to act most rapidly?

5 : A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?

6 : The emergency department nurse is caring for a patient with a suspected anaphylactic reaction to peanuts. What are the 4 (four) possible clinical manifestations of anaphylactic shock? Select the four correct answers.

7 : Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective?

8 : A patient on the Med-Surg floor who recently had abdominal surgery is now complaining of dizziness, shortness of breath, headache and a racing heart. How should the nurse interpret the following arterial blood gas results: pH 7.32, PaO2 87 mm Hg, PaCO2 48 mm Hg, and HCO3 30 mEq/L?

9 : Which item should the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?

10 : A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening. What is the most immediate nursing goal for this patient?

1 :
A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

2 :
A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128, respirations 28. The pulmonary artery wedge pressure (PAWP) is increased and cardiac output is low. The nurse will anticipate an order for which medication?

3 :
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to limit foods high in purines. Which of the following foods should be limited?

4 :
The nurse is evaluating the response to treatment for a patient that has recently started taking furosemide to treat stage 2 hypertension. Which clinical findings will require the nurse to act most rapidly?

5 :
A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?

6 :
The emergency department nurse is caring for a patient with a suspected anaphylactic reaction to peanuts. What are the 4 (four) possible clinical manifestations of anaphylactic shock? Select the four correct answers.

7 :
Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective?

8 :
A patient on the Med-Surg floor who recently had abdominal surgery is now complaining of dizziness, shortness of breath, headache and a racing heart. How should the nurse interpret the following arterial blood gas results: pH 7.32, PaO2 87 mm Hg, PaCO2 48 mm Hg, and HCO3 30 mEq/L?

9 :
Which item should the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?

10 :
A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening. What is the most immediate nursing goal for this patient?