Nokea
A client with angina will have to make lifestyle modifications. Which of the following statements by the client would indicate that he understands the necessary modifications in lifestyle to prevent angina attacks?
- A. I know that I will need to eat less, so I will only eat one meal a day.'
- B. I will need to stay in bed all the time so I won't have the pain.'
- C. I'll stop what I'm doing whenever I have pain and take a pill.'
- D. I will need to walk more slowly and rest frequently to avoid the angina.'
Correct Answer: D
Rationale: Walking slowly and resting frequently helps prevent angina by reducing cardiac workload. Eating one meal a day, staying in bed, or only stopping during pain do not address preventive lifestyle modifications.
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Which statement by the client indicates an understanding of what will happen during the testing procedure?
- A. I will be able to hear my heart beating in my chest.
- B. I will feel a heavy sensation all over my body.
- C. I will be anesthetized and will not feel any discomfort.
- D. I will feel a warm sensation as the dye is instilled.
Correct Answer: D
Rationale: During a coronary arteriogram, the injection of contrast dye often causes a warm or flushing sensation as it circulates.
Please indicate with an X the best anatomic area for the nurse to auscultate mitral valve sounds.
- A. Apex of the heart
- B. Second right intercostal space
- C. Second left intercostal space
- D. Lower left sternal border
Correct Answer: A
Rationale: Mitral valve sounds are best heard at the apex (fifth intercostal space, midclavicular line).
When auscultating the client's heart and breath sounds during a routine shift assessment, which action by the nurse is most appropriate?
- A. Asking the client to hold the breath
- B. Using the bell of the stethoscope
- C. Positioning the client flat in bed
- D. Locating the xiphoid process
Correct Answer: B
Rationale: The bell of the stethoscope is best for low-pitched heart sounds in pericarditis.
A client has an elevated AST 24 hours following chest pain and shortness of breath. This is suggestive of which of the following?
- A. Gallbladder disease
- B. Liver disease
- C. Myocardial infarction
- D. Skeletal muscle injury
Correct Answer: C
Rationale: AST is an enzyme released in response to tissue damage. The symptoms of chest pain and shortness of breath, along with elevated AST 24 hours later, are suggestive of myocardial infarction. AST rises after a myocardial infarction but may also rise with liver damage or skeletal muscle injury. Gallbladder disease typically presents with pain in the right scapula region and would not have an elevated AST.
An adult client with peripheral vascular disease tells the nurse he is afraid his left leg is not improving and may need to be amputated. How should the nurse respond?
- A. You and your wife should discuss your feelings before surgery.'
- B. You sound concerned about your leg and possible surgery.'
- C. It is better to have an amputation when the ulcers are not improving.'
- D. You don't need to be afraid of surgery.'
Correct Answer: B
Rationale: Reflecting the client’s concern encourages open communication and validates his feelings, promoting therapeutic dialogue.