The nurse is caring for a client who is receiving the ACE inhibitor lisinopril. Which of the following outcomes should the nurse anticipate?

Decreased heart rate.

Decrease in chest pain.

Hypokalemia.

Decreased blood pressure.

Answer and Explanation

The Correct Answer is D

Choice A reason: A decreased heart rate is not a typical outcome of ACE inhibitor therapy. ACE inhibitors primarily work by relaxing blood vessels, which lowers blood pressure. They do not directly affect the heart rate. While some blood pressure medications can influence heart rate, this is not a common effect of ACE inhibitors like lisinopril.

Choice B reason: A decrease in chest pain is also not a primary outcome of ACE inhibitor therapy. While lowering blood pressure can help reduce the workload on the heart and potentially decrease angina (chest pain), this is more of an indirect effect. ACE inhibitors are primarily used for hypertension and heart failure, not specifically for pain relief.

Choice C reason: Hypokalemia, or low potassium levels, is not an expected outcome of taking an ACE inhibitor. In fact, ACE inhibitors can lead to hyperkalemia (high potassium levels) because they decrease aldosterone production, which causes the body to retain potassium. Patients on ACE inhibitors are often monitored for signs of hyperkalemia rather than hypokalemia.

Choice D reason: The correct and expected outcome of taking lisinopril, an ACE inhibitor, is decreased blood pressure. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing levels of angiotensin II, ACE inhibitors help relax blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood. This is the primary therapeutic effect of the medication.

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

Explanation

Choice A reason: Providing at least 5000 kcal/day is essential for a patient with burn injuries. Burns significantly increase the body's metabolic rate and caloric needs to support the healing process and prevent catabolism. Ensuring an adequate caloric intake helps meet the energy demands required for tissue repair and recovery.

Choice B reason: Starting an oral diet on the first day may not be appropriate for all burn patients, particularly those with extensive burns or those who are not yet stable. Nutrition needs should be carefully assessed, and feeding may begin via alternative methods such as enteral nutrition until the patient is ready for oral intake.

Choice C reason: Administering a diet high in protein is crucial for burn patients, as protein is essential for wound healing, maintaining lean body mass, and supporting the immune system. Protein intake should be increased to help repair damaged tissues and promote recovery.

Choice D reason: Collaborating with a registered dietitian is important to create an individualized nutrition plan that meets the specific needs of the burn patient. A dietitian can provide expertise in calculating caloric and protein requirements, recommending appropriate supplements, and monitoring the patient's nutritional status.

Choice E reason: Offering frequent high-calorie snacks helps ensure that the patient meets their increased caloric needs. Small, frequent meals and snacks can be more manageable for patients with reduced appetite or those who have difficulty consuming large meals. High-calorie snacks provide additional energy to support healing and recovery.

A. BP 110/62, atrial fibrillation with HR 82, bilateral basilar crackles. B. Weight gain of 1 kg in 3 days, BP 130/80, mild dyspnea with exercise. C. SpO2 92% on 2L nasal cannula, respirations 20/min, 1+ edema of lower extremities. D. Confusion, urine output 15 mL over the last 2 hours, orthopnea.

Correct Answer is D

Explanation

Choice A reason: While atrial fibrillation, bilateral basilar crackles, and a blood pressure of 110/62 indicate important findings in a client with heart failure, they are not immediately life-threatening compared to the symptoms in choice d. Bilateral crackles suggest fluid overload and pulmonary congestion, which require attention, but the priority should be on more critical signs of decreased perfusion.

Choice B reason: Weight gain of 1 kg in 3 days and mild dyspnea with exercise are signs of fluid retention and worsening heart failure. However, they are not as urgent as the symptoms of confusion and low urine output, which suggest severe hypoperfusion and potential organ failure.

Choice C reason: A SpO2 of 92% on 2L nasal cannula, respirations of 20/min, and 1+ edema of the lower extremities indicate mild hypoxemia and fluid overload. Although these findings are important and need management, they are not as critical as the symptoms in choice d, which suggest severe hypoperfusion and a potential emergency.

Choice D reason: Confusion, urine output of 15 mL over the last 2 hours, and orthopnea are the most concerning findings. Confusion indicates decreased cerebral perfusion, which is a sign of severe heart failure and possibly impending cardiogenic shock. Low urine output (oliguria) suggests poor renal perfusion, indicating that the kidneys are not receiving enough blood flow. Orthopnea (difficulty breathing while lying down) is a classic symptom of severe heart failure and pulmonary congestion. These symptoms suggest that the client is in a critical condition that requires immediate intervention to improve perfusion and prevent further deterioration.

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The nurse is caring for a client who is receiving the ACE inhibitor lisinopril. Which of the following outcomes should the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse plans care for a patient with burn injuries. Which interventions would the nurse include in this patient's plan of care to ensure adequate nutrition? Select all that apply.

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

Explanation

The nurse has completed an assessment on a client with heart failure and a decreased cardiac output with an ejection fraction of 30%. Which finding should receive the highest priority?

Correct Answer is D

Explanation

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