The nurse is caring for a patient with heart failure who is receiving lisinopril twice a day. What intervention will the nurse implement when administering this medication?

Hold medication if B-type natriuretic peptide (BNP) results are high.

Check serum potassium and creatinine levels.

Encourage the patient to add salt substitute with all meals.

Document extent of vision changes every shift.

Answer and Explanation

The Correct Answer is B

Choice A reason: Holding medication if B-type natriuretic peptide (BNP) results are high is not a standard intervention when administering lisinopril. BNP levels are used to assess the severity of heart failure, but they do not directly influence the administration of lisinopril. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that helps manage heart failure by reducing blood pressure and decreasing the workload on the heart.

Choice B reason: Checking serum potassium and creatinine levels is crucial when administering lisinopril. Lisinopril can affect kidney function and electrolyte balance. It may cause hyperkalaemia (elevated potassium levels) and increase serum creatinine levels, indicating impaired kidney function. Regular monitoring of these parameters helps ensure the patient's safety and the effectiveness of the medication.

Choice C reason: Encouraging the patient to add salt substitute with all meals is not recommended for patients taking lisinopril. Many salt substitutes contain potassium chloride, which can further increase the risk of hyperkalaemia in patients on ACE inhibitors like lisinopril. This intervention could lead to dangerous electrolyte imbalances.

Choice D reason: Documenting the extent of vision changes every shift is not related to the administration of lisinopril. Vision changes are not a common side effect of this medication. This intervention may be more relevant for patients on medications known to affect vision, but it is not specific to lisinopril.

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Correct Answer is D

Explanation

Choice A reason: Family history of common bile duct disorder is not a known trigger for irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder with multifactorial causes, including but not limited to genetics, gut-brain axis, and environmental factors. Bile duct disorders and IBS have different pathophysiological mechanisms and are not directly linked.

Choice B reason: The frequent occurrence of blood in the stool is not a cause of IBS. Blood in the stool is more indicative of other gastrointestinal conditions such as inflammatory bowel disease (IBD), colorectal cancer, or haemorrhoids. IBS is characterized by abdominal pain, bloating, and changes in bowel habits without organic pathology such as bleeding.

Choice C reason: While there is some evidence suggesting that individuals with a family history of psychiatric disorders and food allergies may have a higher prevalence of IBS, it is not the main cause. These factors may contribute to the onset and exacerbation of symptoms but are part of a broader spectrum of triggers, including genetics, stress, and gut microbiota.

Choice D reason: Environmental and psychosocial factors are indeed associated with the onset of IBS. Factors such as stress, anxiety, depression, and traumatic life events can play a significant role in the development and exacerbation of IBS symptoms. Additionally, environmental factors like diet, infections, and changes in gut microbiota are known to influence IBS. This choice aligns with current evidence-based understanding of the condition.

A. The patient is increasingly drowsy and hard to arouse. B. The patient's feet and hands are covered with red, raised purpura.

Correct Answer is A

Explanation

Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.

Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.

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The nurse is caring for a patient with heart failure who is receiving lisinopril twice a day. What intervention will the nurse implement when administering this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with a new diagnosis of irritable bowel syndrome (IBS). The patient is upset and concerned about how they got IBS. What evidence-based information, related to the causes of IBS, will the nurse provide to this patient?

Correct Answer is D

Explanation

The nurse is caring for a patient with idiopathic thrombocytopenic purpura (ITP) whose platelet count is 10,000/mm³. What assessment finding will the nurse report to the provider immediately?

Correct Answer is A

Explanation

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