Nokea
A client is being evaluated for coronary artery disease (CAD) and is scheduled for an electron beam computed tomography (EBCT). The nurse understands that the primary advantage of this radiologic test is which of the following?
- A. Less exposure to radiation
- B. Clear images
- C. Less invasive procedure
- D. Quantifies calcified plaque
Correct Answer: D
Rationale: The primary advantage of EBCT is to detect and quantify calcified plaque in the coronary arteries even before symptoms arise. EBCT is noninvasive and provides clearer images with less exposure to radiation than a CT scan but not the primary reason for use.
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The nurse knows that women and older adults are at greater risk for a fatal myocardial event. Which factor is the primary contributor of this cause?
- A. Chest pain is typical
- B. Vague symptoms
- C. Decreased sensation to pain
- D. Gender bias
Correct Answer: B
Rationale: Often, women and older adults do not have the typical chest pain associated with a myocardial infarction. Some report vague symptoms (fatigue, abdominal pain), which can lead to misdiagnosis. Some older adults may experience little or no chest pain. Gender is not a contributing factor for fatal occurrence but rather a result of symptoms association.
Clients taking vasodilator drugs have a greater risk for postprandial hypotension. Which of the following is the best nursing explanation for this phenomenon?
- A. Gravity pulls blood to the lower extremities while sitting
- B. Blood is being diverted to the gastrointestinal tract
- C. Decreased peripheral blood flow results
- D. Bronchospasms are increased when food enters the stomach
Correct Answer: B
Rationale: During digestion, blood is diverted to the GI tract which decreases cerebral blood flow and increases potential of orthostatic hypotension. Although gravity does pull blood to the lower extremities while sitting, this is not the primary concern with postprandial hypotension. Decreased peripheral blood flow does not result in postprandial hypotension. Bronchospasms are associated more with asthma not diversion of blood flow.
The nurse is caring for a client who is post-varicose vein surgery. The nurse would include which teaching measure(s)? Select all that apply.
- A. Exercise
- B. Cool compresses
- C. Elastic stockings
- D. Lower the extremities
- E. Stand rather than sit
- F. Take warm showers in the morning
Correct Answer: A,C
Rationale: Movement/exercise and use of elastic stocking aid in venous return. Cool compresses can cause vasoconstriction, which can diminish arterial blood flow. Elevation of legs can be helpful in aiding venous return. Standing or sitting for prolonged periods of time should be avoided. Showers in the morning can dilate blood vessels and contribute to venous congestion and edema.
The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD?
- A. Assess the client's mental and emotional status
- B. Assess the skin of the client
- C. Assess the characteristics of chest pain
- D. Assess for any kind of drug abuse
Correct Answer: C
Rationale: The nurse should assess the characteristics of chest pain for a client with CAD. Assessing the client's mental and emotional status, skin, or for drug abuse will not assist the nurse in evaluating the client for CAD. The assessment should be aimed at evaluating for adequate blood flow to the heart.
The nurse is working with a client who has just been diagnosed with an aneurysm. What advice should the nurse provide to this client?
- A. Minimize bowel movements and coughing
- B. Avoid situations that contribute to ischemic episodes
- C. Avoid straining during bowel movements and coughing
- D. Wear wool socks and mittens during cold weather
Correct Answer: C
Rationale: The nurse advises the client with an aneurysm to avoid straining during bowel movements and coughing. Coughing and straining increase the risk of rupture. The client with Raynaud syndrome is asked to avoid situations that contribute to ischemic episodes and to wear wool socks and mittens during cold weather.