A nurse is assessing a client who is taking lisinopril. Which of the following findings should the nurse document in the client's medical record as an adverse effect?

Blood pressure 108/62 mm Hg

Potassium 3.5 mEq/L (3.5 to 5 mEq/L)

Frequent, nonproductive cough

Frequent, painless urination

Answer and Explanation

The Correct Answer is C

A. Blood pressure 108/62 mm Hg: Lisinopril is an antihypertensive, and a systolic BP above 90 mm Hg is typically not considered an adverse effect. Hypotension can occur but is more concerning if it results in symptoms such as dizziness or syncope.

B. Potassium 3.5 mEq/L (3.5 to 5 mEq/L): Lisinopril can cause hyperkalemia, but a potassium level of 3.5 mEq/L is within the normal range. Monitoring potassium levels is essential, but this finding does not indicate an adverse effect.

C. Frequent, nonproductive cough: A dry, persistent cough is a common adverse effect of lisinopril due to the accumulation of bradykinin. It often does not resolve until the medication is discontinued or switched to an alternative, such as an angiotensin receptor blocker (ARB).

D. Frequent, painless urination: Lisinopril does not typically cause increased urination. While it affects renal function, it is more likely to lead to hyperkalemia or reduced glomerular filtration rate in susceptible individuals.

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Correct Answer is C

Explanation

A. Increased body hair: Adrenal insufficiency leads to decreased androgen production, which may cause hair thinning rather than increased body hair. Hypertrichosis (excessive hair growth) is not a typical finding in adrenal insufficiency.

B. Decreased blood urea nitrogen level: Adrenal insufficiency is often associated with dehydration due to aldosterone deficiency, leading to reduced sodium retention and increased fluid loss. This can result in elevated blood urea nitrogen (BUN) levels rather than a decrease.

C. Hyperpigmentation of the skin: Increased melanocyte-stimulating hormone (MSH) activity, triggered by elevated adrenocorticotropic hormone (ACTH) levels, causes darkening of the skin, especially in sun-exposed areas, skin folds, and mucous membranes. This is a hallmark feature of primary adrenal insufficiency (Addison’s disease).

D. Hypocalcemia: Adrenal insufficiency is more commonly associated with hypercalcemia rather than hypocalcemia. Decreased cortisol levels can lead to reduced renal calcium excretion, contributing to elevated serum calcium levels.

A. Drink 3 L of fluids daily. B. Take a warm bubble bath daily. C. Drink low-fructose cranberry juice. D. Void every 6 hr during the day. E. Wipe the perineal area from front to back after urinating.

Correct Answer is ["A","C","E"]

Explanation

A. Drink 3 L of fluids daily: Increasing fluid intake helps flush bacteria from the urinary tract and dilutes urine, reducing the risk of infection. Adequate hydration also promotes more frequent urination, which prevents bacterial colonization in the bladder.

B. Take a warm bubble bath daily: Bubble baths can introduce irritants and disrupt the normal vaginal flora, increasing the risk of urinary tract infections. Soaking in bathwater containing soap or fragrances can also promote bacterial growth and irritation of the urethra.

C. Drink low-fructose cranberry juice: Cranberry juice contains compounds that help prevent bacteria, particularly Escherichia coli, from adhering to the bladder wall. Low-fructose options are preferred to minimize excessive sugar intake, which can contribute to bacterial growth.

D. Void every 6 hr during the day: Holding urine for long periods allows bacteria to multiply in the bladder, increasing the risk of infection. Voiding every 2 to 4 hours is recommended to promote bladder emptying and reduce bacterial colonization.

E. Wipe the perineal area from front to back after urinating: Wiping from front to back prevents the transfer of bacteria from the anal region to the urethra. This simple hygiene practice helps reduce the risk of E. coli contamination, a leading cause of urinary tract infections.

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A nurse is assessing a client who is taking lisinopril. Which of the following findings should the nurse document in the client's medical record as an adverse effect?

Nursing Test Bank

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