Apply The Patho
A patient with left-sided heart failure reports orthopnea and a new cough at night. Based on pathophysiology, explain why these symptoms occur and one nursing intervention
Pulmonary congestion occurs due to backup of blood into the lungs. High Fowler’s positioning decreases venous return and improves oxygenation.
A patient begins actively seizing in bed. What is the nurse’s first action?
Stay with the patient and protect the airway by turning them on their side.
Which lab value is most specific for diagnosing acute pancreatitis?
Elevated serum lipase.
Why are ACE inhibitors first-line therapy for heart failure?
They reduce afterload through vasodilation, making it easier for the heart to pump.
What safety teaching is most important for a patient with tonic-clonic seizures?
Do not place objects in the mouth during a seizure and ensure environmental safety.
A patient with acute pancreatitis has Cullen sign and Grey Turner sign. Analyze what these findings indicate about disease severity.
They indicate retroperitoneal bleeding and severe inflammation, suggesting hemorrhagic pancreatitis and risk for systemic inflammatory response.
A patient with ulcerative colitis suddenly develops abdominal distention, fever, and tachycardia. Analyze the situation and state the priority action.
A patient with ulcerative colitis suddenly develops abdominal distention, fever, and tachycardia. Analyze the situation and state the priority action.
A patient with heart failure has an elevated BNP. Analyze what this reflects about cardiac function.
Ventricular stretching due to fluid overload and decreased cardiac output
A patient on digoxin reports nausea and yellow-tinged vision. Analyze the nurse’s concern
Suspected digoxin toxicity, possibly worsened by hypokalemia.
A patient with venous insufficiency has edema and ankle ulcers. Which teaching improves venous return?
Elevate legs and use compression stockings.
A patient with glomerulonephritis has edema, hypertension, and cola-colored urine. Which lab result best evaluates worsening renal function, and why?
Rising BUN and creatinine indicate decreased glomerular filtration and worsening kidney impairment
After administering IV furosemide for acute pulmonary edema, which finding best indicates effectiveness?
Decreased crackles, improved oxygen saturation, and increased urine output.
An OCD patient has taken SSRIs for 2 weeks and reports no improvement. Evaluate the nurse’s best response.
Educate that SSRIs may take several weeks to achieve symptom improvement; reinforce adherence.
A patient with OCD stops taking fluoxetine abruptly. Evaluate the risk associated with this action.
Risk for symptom relapse and withdrawal effects; SSRIs should not be stopped abruptly.
A patient with OCD avoids leaving home due to contamination fears. Evaluate the most effective long-term therapy.
Cognitive behavioral therapy with exposure and response prevention.
A patient with Crohn’s disease reports RLQ pain, weight loss, and steatorrhea. Develop one priority nursing goal and one intervention.
Goal: Improve nutritional status. Intervention: Initiate high-protein diet and administer vitamin B12 injections due to ileal involvement.
A patient with OCD repeatedly washes hands until skin breakdown occurs. Prioritize the most therapeutic nursing response.
Acknowledge anxiety without reinforcing the compulsion and encourage participation in exposure and response prevention therapy.
A patient with PAD and diabetes has a painful ulcer on the toes. Which diagnostic test best evaluates arterial perfusion?
Ankle-brachial index (ABI).
Which medication should be anticipated as first-line treatment for status epilepticus?
IV benzodiazepines such as lorazepam.
Create one discharge teaching point for a patient newly diagnosed with heart failure to prevent readmission.
Daily weights with instructions to report weight gain >2 lbs/day or >5 lbs/week.
A patient with heart failure, chronic kidney disease, and OCD is admitted with fluid overload and anxiety-driven medication nonadherence. Prioritize two nursing actions that address both physiologic stability and mental health needs.
Administer prescribed diuretics and provide therapeutic communication to address anxiety and reinforce medication adherence.
A patient simultaneously experiences status epilepticus and aspiration risk. Rank the nurse’s priority actions from first to last.
Maintain airway → administer IV benzodiazepine → provide oxygen and suction → prepare for intubation if needed
A patient with glomerulonephritis develops crackles, weight gain, and rising creatinine. Interpret the labs and assessments to identify the most dangerous complication.
Fluid overload leading to pulmonary edema due to impaired renal filtration.
A patient with heart failure, chronic kidney disease, and hyperkalemia requires medication adjustment. Which class should the nurse question first and why?
ACE inhibitors or potassium-sparing diuretics due to risk of worsening hyperkalemia.
The nurse is educating a patient with seizures, HF, and OCD. Which statement by the patient best demonstrates successful learning?
"I will take my medications daily, monitor my weight, avoid seizure triggers, and continue therapy even if I feel anxious.”