Nokea
A client who has been treated for angina is discharged in stable condition. At a clinic visit, he tells the nurse he has anginal pain when he has sexual intercourse with his wife. What is the best response for the nurse to make?
- A. Do you have ambivalent feelings toward your wife?'
- B. Many persons with angina have less pain when their partner assumes the top position.'
- C. Be sure that you attempt intercourse only when you are well rested and relaxed.'
- D. You might try having a cocktail before sexual activity to help you relax.'
Correct Answer: C
Rationale: Engaging in sexual activity when well-rested and relaxed reduces cardiac demand, minimizing angina risk. Questioning feelings, suggesting positions, or recommending alcohol are less appropriate or potentially harmful.
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Which risk factor is least likely to have predisposed the client to having a myocardial infarction (MI)?
- A. Smoking cigarettes
- B. Eating fatty foods
- C. Working under emotional stress
- D. Drinking an occasional cocktail
Correct Answer: D
Rationale: Occasional alcohol consumption is the least significant MI risk factor compared to smoking, high-fat diets, and chronic stress.
When the client returns to the room after the percutaneous transluminal coronary angioplasty (PTCA) procedure, which assessment finding should be reported immediately to the physician?
- A. Urine output of 100 mL/hour
- B. Blood pressure of 108/68 mm Hg
- C. Dry mouth
- D. Chest pain
Correct Answer: D
Rationale: Chest pain post-PTCA may indicate re-occlusion or complications like stent thrombosis, requiring immediate reporting.
Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial infarction (MI)?
- A. Creatine kinase (CK-MB).
- B. Lactate dehydrogenase (LDH).
- C. Troponin.
- D. White blood cells (WBCs).
Correct Answer: C
Rationale: Troponin (C) rises within 3–4 hours post-MI, making it the earliest marker. CK-MB (A) rises in 4–6 hours, LDH (B) in 24–48 hours, and WBCs (D) are nonspecific.
Which assessment finding documented by the nurse provides the best evidence that the client has a bacterial infection?
- A. Chest pain
- B. Dry cough
- C. Fever
- D. Dyspnea
Correct Answer: C
Rationale: Fever is a hallmark of bacterial infection, such as in endocarditis.
Which nursing action is most appropriate when applying a new transdermal patient?
- A. Rotate the application site.
- B. Clean the skin with alcohol.
- C. Tape the patch to the client's chest.
- D. Take the blood pressure afterward.
Correct Answer: A
Rationale: Rotating the application site for a nitroglycerin patch prevents skin irritation and ensures consistent drug absorption.