Nokea
A client is being discharged following the insertion of a permanent pacemaker. Which of the following should be included in the client's discharge instructions?
- A. Air travel will not be possible due to airport screening equipment.
- B. You will need to discard any radios at home that have antennas.
- C. Computed tomography (CT) scans are not permitted with this device.
- D. You should use your cellular phone on the opposite side of the generator.
Correct Answer: D
Rationale: Using a cell phone on the opposite side of the pacemaker reduces electromagnetic interference.
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History of Present Illness (HPI)
The client was found disoriented upon arrival and in acute respiratory distress.
The client's caregiver noted that the prescribed medications had not been
taken for several days. Medical history includes hypertension, diabetes mellitus,
congestive heart failure, and arthritis. Client Assessment Bounding peripheral pulses,
normotensive, crackles in the lung fields, tachypnea, jugular venous distention, and
abdominal distention.
Diagnosis
1. Pulmonary edema
2. Acute decompensated heart failure
Based on the clinical data, which prescription would the nurse request from the primary healthcare provider for a client with pulmonary edema and acute decompensated heart failure? Select all that apply.
- A. Albuterol
- B. Hydrocortisone
- C. Diltiazem
- D. Nitroglycerin
- E. Furosemide
Correct Answer: D,E
Rationale: Albuterol is for bronchospasm, not pulmonary edema. B: Incorrect - Hydrocortisone is not indicated for heart failure. C: Incorrect - Diltiazem is for rate control, not fluid overload. D: Correct - Nitroglycerin reduces preload, alleviating pulmonary edema. E: Correct - Furosemide is a diuretic to reduce fluid overload.
The nurse is caring for a client who appears to be developing heart failure (HF). Which of the following laboratory tests would the nurse expect the primary health care provider (PHCP) to prescribe to confirm the diagnosis?
- A. Basic metabolic panel (BMP)
- B. B-type natriuretic peptide (BNP)
- C. Lipid profile
- D. Troponin
Correct Answer: B
Rationale: BNP is a specific biomarker elevated in heart failure, reflecting ventricular stress and fluid overload.
The nurse is caring for a client in the emergency department, reporting a headache and generalized flushing. The nurse should request a prescription for which medication? See the exhibit for additional client information.
- A. enalapril
- B. labetalol
- C. amiodarone
- D. nitroglycerin
Correct Answer: B
Rationale: Headache and flushing in a hypertensive crisis suggest the need for labetalol, a beta-blocker, to control blood pressure.
The nurse is providing discharge teaching to a client following coronary artery bypass graft (CABG) surgery. The nurse should advise the client that they may resume sexual activity
- A. after exercise tolerance is assessed.
- B. one week after surgery.
- C. when the client can comfortably jog two miles.
- D. three months after surgery.
Correct Answer: A
Rationale: Sexual activity can resume after CABG once exercise tolerance is confirmed, typically when the client can climb two flights of stairs without symptoms.
The nurse is discharging a client with heart failure who is prescribed digoxin and furosemide. Which of the following laboratory tests must the client have monitored due to this combination of prescribed medications?
- A. Fecal occult blood
- B. Serum electrolytes
- C. Urinalysis
- D. Glycosylated hemoglobin
Correct Answer: B
Rationale: Furosemide can cause hypokalemia, increasing digoxin toxicity risk, so serum electrolytes (especially potassium) must be monitored.