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A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin 0.4 mg sublingually. Five minutes later, the client is still experiencing chest pain. What is the next appropriate nursing action?
- A. Administer another dose of nitroglycerin.
- B. Notify the healthcare provider immediately.
- C. Have the client lie down and stay calm.
- D. Give the client aspirin 325 mg to chew.
Correct Answer: A
Rationale: If chest pain persists after the first dose of nitroglycerin, it is appropriate to administer a second dose while continuing to monitor the client's response. Nitroglycerin is a vasodilator commonly used to relieve angina symptoms by dilating blood vessels and increasing blood flow to the heart. Reassessing the client's response and providing a second dose may be necessary to achieve adequate pain relief and improve blood flow to the heart.
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A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?
- A. Presence of ascites
- B. Bilateral lung crackles
- C. Jugular vein distention
- D. Pedal edema bilaterally
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client with myocardial infarction should reduce intake of saturated fat and cholesterol. Which food items from the dietary menu would assist the nurse in helping the client comply with diet therapy?
- A. Cheeseburger, pan-fried potatoes, whole kernel corn, sherbet
- B. Pork chop, baked potato, cauliflower in cheese sauce, ice cream
- C. Baked haddock, steamed broccoli, herbed rice, sliced strawberries
- D. Spaghetti and sweet sausage in tomato sauce, vanilla pudding (with 4% milk)
Correct Answer: C
Rationale: Option C, which includes baked haddock, steamed broccoli, herbed rice, and sliced strawberries, is the most appropriate choice for a client with myocardial infarction looking to reduce saturated fat and cholesterol intake. This meal is low in saturated fats and cholesterol, making it a heart-healthy option that aligns with the dietary recommendations for such clients.
A healthcare provider is assisting in the care of a client who is having central venous pressure (CVP) measurements taken. The healthcare provider should assist by placing the bed in which position for the reading?
- A. Flat
- B. Semi-Fowler's
- C. Trendelenburg
- D. Reverse Trendelenburg
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The healthcare provider has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?
- A. I should substitute eggs and milk for meat.
- B. I will eliminate all cholesterol and fat from my diet.
- C. I should routinely use polyunsaturated oils in my diet.
- D. I need to consider becoming a strict vegetarian.
Correct Answer: C
Rationale: The correct answer is C. Using polyunsaturated oils, such as vegetable oils, can help manage cholesterol levels and reduce the risk of heart disease. This dietary change is beneficial for individuals with coronary artery disease as it promotes heart health by improving cholesterol profiles. Substituting eggs and milk for meat (Choice A) may not address the overall dietary needs for managing the condition. Completely eliminating all cholesterol and fat from the diet (Choice B) is not necessary as the body needs some healthy fats. Considering becoming a strict vegetarian (Choice D) is a personal choice and may not necessarily be required to manage coronary artery disease.
A client with a diagnosis of angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?
- A. I am considering cutting my workload.
- B. I need to cut down on cigarette smoking.
- C. I am so relieved that my heart is repaired.
- D. I need to adhere to my dietary restrictions.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.