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A nurse is caring for a patient who has had a myocardial infarction. Which of the following medications should the nurse expect to be prescribed for this patient?

  • A. Lisinopril.
  • B. Acetaminophen.
  • C. Furosemide.
  • D. Hydrochlorothiazide.
Correct Answer: A

Rationale: Step 1: Lisinopril is an ACE inhibitor commonly prescribed post-myocardial infarction to reduce strain on the heart and prevent further damage.
Step 2: ACE inhibitors like Lisinopril help lower blood pressure and improve heart function.
Step 3: By reducing the workload on the heart, Lisinopril can help prevent complications post-MI.
Step 4: Acetaminophen (B) is a pain reliever and does not address the cardiovascular issues post-MI.
Step 5: Furosemide (C) and Hydrochlorothiazide (D) are diuretics typically used for managing fluid retention, not the primary focus after an MI.
Summary: Lisinopril is the correct choice as it helps improve heart function and prevent complications post-MI, unlike the other options which do not directly address the cardiovascular issues associated with MI.

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A patient with chronic kidney disease (CKD) is being assessed. The nurse would expect to find which of the following symptoms?

  • A. Weight loss and polyphagia.
  • B. Edema and proteinuria.
  • C. Hypertension and tachycardia.
  • D. Hypothermia and bradycardia.
Correct Answer: B

Rationale: The correct answer is B: Edema and proteinuria. In CKD, the kidneys are unable to filter waste products effectively, leading to fluid retention (edema) and protein leaking into the urine (proteinuria). Edema occurs due to fluid buildup from decreased kidney function. Proteinuria is a result of damaged glomeruli in the kidneys, allowing proteins to leak into the urine. Weight loss and polyphagia (excessive hunger) are not typical symptoms of CKD. Hypertension and tachycardia can occur in CKD due to fluid overload and electrolyte imbalances. Hypothermia and bradycardia are not common symptoms of CKD and would be more indicative of other conditions.

What should a nurse assess for in a client with an arteriovenous fistula for hemodialysis?

  • A. Inspect for visible pulsation
  • B. Palpate for thrill
  • C. Auscultate for bruit
  • D. Percuss for dullness
Correct Answer: A

Rationale: The correct answer is A: Inspect for visible pulsation. This is because an arteriovenous fistula for hemodialysis should have a visible pulsation, indicating proper blood flow. Palpating for thrill (B) and auscultating for bruit (C) are also common assessments for an arteriovenous fistula, but inspecting for visible pulsation is the most direct and reliable way to assess the patency of the fistula. Percussing for dullness (D) is not relevant in this context as it does not provide information about the vascular access site.

Which nursing intervention should be prioritized for a client with congestive heart failure (CHF)?

  • A. Administer diuretics
  • B. Limit fluid intake
  • C. Promote activity
  • D. Maintain fluid balance
Correct Answer: C

Rationale: Rationale for Correct Answer (C): Promoting activity is the most prioritized nursing intervention for a client with CHF. Activity helps improve cardiac function, decreases fluid accumulation, and enhances overall cardiovascular health. It also prevents complications like muscle weakness and deconditioning. It is crucial in managing CHF symptoms and improving the client's quality of life.

Summary of Incorrect Choices:
A: Administering diuretics helps in reducing fluid overload but does not address the underlying issue of improving cardiac function through physical activity.
B: Limiting fluid intake is important, but promoting activity takes precedence as it directly impacts cardiac function and fluid accumulation.
D: Maintaining fluid balance is necessary but is a broad concept that includes various interventions, with promoting activity being more focused and critical in CHF management.

What is the most appropriate action for a client with a history of asthma who is experiencing wheezing?

  • A. Administer albuterol
  • B. Administer antihistamines
  • C. Monitor for signs of infection
  • D. Administer epinephrine
Correct Answer: A

Rationale: The correct answer is A: Administer albuterol. Albuterol is a bronchodilator that helps open the airways, relieving wheezing in asthma patients. It is the first-line treatment for acute asthma exacerbations. Antihistamines (B) do not treat asthma symptoms. Monitoring for infection (C) is important but not the immediate action for wheezing. Epinephrine (D) is used for severe allergic reactions, not routine asthma management.

What is the most appropriate action when a client experiences chest pain and has a history of myocardial infarction?

  • A. Administer nitroglycerin
  • B. Administer aspirin
  • C. Administer morphine
  • D. Administer beta blockers
Correct Answer: A

Rationale: The correct answer is A: Administer nitroglycerin. Nitroglycerin is the recommended initial medication for chest pain in a client with a history of myocardial infarction. It helps dilate blood vessels, improving blood flow to the heart, and reducing chest pain. Aspirin (choice B) is also usually given to reduce blood clot formation, but nitroglycerin is the priority for immediate relief. Morphine (choice C) may be used if nitroglycerin is ineffective, and beta blockers (choice D) are typically used for long-term management of heart conditions, not for immediate relief of chest pain.

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