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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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A low-sodium, low-cholesterol, weight-reducing diet is prescribed for an adult with heart disease. The nurse knows that he understands his diet when he chooses which of the following meals?
- A. Baked skinless chicken and mashed potatoes
- B. Stir-fried Chinese vegetables and rice
- C. Tuna fish salad with celery sticks
- D. Grilled lean steak Ascertainly grilled lean steak with carrots
Correct Answer: A
Rationale: Baked skinless chicken and mashed potatoes are low in sodium and cholesterol, making them suitable for a heart-healthy diet. Stir-fried vegetables may contain high sodium sauces, tuna salad may include high-sodium dressings, and grilled steak is higher in cholesterol.
When the nurse is obtaining this client's health history, which question about pain is least helpful?
- A. How long have you been in pain?
- B. Where is your pain located?
- C. What were you doing when your pain started?
- D. What medications do you take for pain?
Correct Answer: D
Rationale: Asking about pain medications is less critical in the acute MI setting compared to timing, location, and triggers, which guide diagnosis and urgency.
The nurse provides discharge instructions for a client who has recovered after a cardiac catheterization. Which instructions should be included? Select all that apply.
- A. Take a shower rather than a tub bath until the puncture site heals.
- B. Perform leg exercises every 2 hours while awake.
- C. In the generous amount of fluids for the next 24 hours.
- D. Report worsening of pain in the leg that was catheterized.
- E. Flush the toilet twice after eliminating urine and stool in the next 24 hours.
- F. Change the dressing over the puncture site daily until it heals.
Correct Answer: A,C,D
Rationale: Showering prevents infection, generous fluids help flush contrast dye, and reporting worsening pain detects complications. Leg exercises, double flushing, and daily dressing changes are not standard.
Which nursing action is most appropriate to perform next?
- A. The nurse notifies the physician, requesting a hypnotic or sedative.
- B. The nurse provides a video of the surgery for the client to watch.
- C. The nurse waits until the client's spouse is present to excessive the surgery.
- D. The nurse listens as the client talks about fears concerning surgery and rehabilitation.
Correct Answer: D
Rationale: Listening to the client's fears reduces anxiety and supports emotional preparation for surgery.
Which information about the client's use of a patient-controlled analgesia (PCA) pump is most important to communicate to the staff on the next shift?
- A. Name of the client's physician
- B. Purpose for using the pump
- C. Number of doses administered
- D. The client's need for further teaching
Correct Answer: C
Rationale: The number of doses administered is critical for monitoring pain control and preventing overdose.