Nokea
A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of developing the disorder. Which is the best response by the nurse?
- A. Moderation is the key to everything
- B. Ask your physician to prescribe the new reverse lipid drug
- C. Increase the soy in your diet
- D. Exercise, keep your blood sugar in check, and manage your stress
Correct Answer: D
Rationale: Although moderation is the key, this does not provide specific options for this client such as regular exercise and managing stress and cholesterol levels. The reverse lipid drug sounds good but is not available or approved by the FDA. Soy products have limited benefits for cholesterol control.
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The nurse is caring for a client who is suspected of having coronary artery disease. The client is scheduled to have a nuclear stress test using thallium. When would the thallium be injected to determine narrowing of the coronary arteries?
- A. During and a few hours after exercise electrocardiography
- B. Before and during exercise electrocardiography
- C. Before and a few hours after exercise electrocardiography
- D. Before, during, and a few hours after exercise electrocardiography
Correct Answer: A
Rationale: A nuclear stress test using a radionuclide, such as thallium, may be injected intravenously (IV) during and a few hours after exercise electrocardiography, followed by a heart scan. Narrowing of one or more coronary arteries is documented during coronary arteriography.
The nurse is presenting a workshop at the senior citizens center about how the changes of aging predispose clients to vascular occlusive disorders. What would the nurse name as the most common cause of peripheral arterial problems in the older adult?
- A. Arteriosclerosis
- B. Coronary thrombosis
- C. Atherosclerosis
- D. Raynaud's disease
Correct Answer: C
Rationale: Atherosclerosis is the most common cause of peripheral arterial problems in the older adult. The disease correlates with the aging process. The other choices may occur at any age.
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.
A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation?
- A. Prothrombin time (PT) or international normalized ratio (INR)
- B. Hourly IV infusion
- C. Vascular sites for bleeding
- D. Urine output
Correct Answer: A
Rationale: The nurse should monitor PT or INR when oral anticoagulation is prescribed. Vascular sites for bleeding, urine output, and hourly IV infusions are generally monitored in all clients.
A client who is diagnosed with Raynaud syndrome reports cold and numbness in the fingers. Which finding should the nurse identify as an early sign of vasoconstriction?
- A. Pallor
- B. Cyanosis
- C. Gangrene
- D. Ulceration
Correct Answer: A
Rationale: Pallor is the initial symptom in Raynaud syndrome followed by cyanosis and aching pain. Gangrene and ulceration can occur with persistent attacks and interference of blood flow.