Nokea
A male client with angina pectoris has been having an increased number of episodes of pain recently. He is admitted for observation. During the admission interview, he tells the nurse that he has been having chest pain during the last week. Which statement by the client would be of greatest concern to the nurse?
- A. I had chest pain while I was walking in the snow on Thursday.'
- B. We went out for a big dinner to celebrate my wife's birthday, but I couldn't enjoy it because I got the pain before we got home from the restaurant.'
- C. I had chest pain yesterday while I was sitting in the living room watching television.'
- D. I felt pain all the way down my left arm after I was playing with my grandson on Monday.'
Correct Answer: C
Rationale: Chest pain at rest, such as while watching television, is concerning as it may indicate unstable angina or impending myocardial infarction, requiring urgent evaluation. Pain with activity, eating, or radiating to the arm is typical of angina but less immediately alarming.
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Which nursing action can best help reduce the client's anxiety in this situation?
- A. Teach the client how coronary artery disease (CAD) is usually treated.
- B. Listen to the client's feelings about this condition.
- C. Explain that the procedure has been very helpful for other clients.
- D. Avoid discussing the heart catheterization until the client has relaxed.
Correct Answer: B
Rationale: Listening to the client's feelings validates their emotions and reduces anxiety by fostering trust and open communication.
When the client asks why the physician ordered the ECG, how does the nurse correctly explain its purpose?
- A. It will show how the heart performs during exercise.
- B. It will determine the client's potential target heart rate.
- C. It will verify how much the client needs to improve fitness.
- D. It will help predict whether the client will have a heart attack soon.
Correct Answer: A
Rationale: A stress ECG evaluates heart function under physical stress, detecting ischemia or abnormal rhythms indicative of coronary artery disease.
The client is exhibiting sinus bradycardia, is complaining of syncope and weakness, and has a BP of 98/60. Which collaborative treatment should the nurse anticipate being implemented?
- A. Administer a thrombolytic medication.
- B. Assess the client's cardiovascular status.
- C. Prepare for insertion of a pacemaker.
- D. Obtain a permit for synchronized cardioversion.
Correct Answer: C
Rationale: Symptomatic bradycardia (syncope, hypotension) often requires a pacemaker (C). Thrombolytics (A) are for MI, assessment (B) is ongoing, and cardioversion (D) is for tachydysrhythmias.
Which finding would strongly indicate that the cardioversion procedure has been successful?
- A. The client regains consciousness immediately.
- B. Normal sinus cardiac rhythm is restored.
- C. The physical examination of the patient is a second.
- D. The pulse pressure is approximately 40 mm Hg.
Correct Answer: B
Rationale: Restoration of normal sinus rhythm is the primary goal of cardioversion.
When obtaining a health history from this client, which finding strongly suggests that the client is hypertensive? Select all that apply.
- A. Unexplained nosebleeds
- B. Difficulty sleeping at night
- C. Waking to urinate at night
- D. Occasional heart palpitations
- E. Dizziness
- F. Pale skin color
Correct Answer: A,C,E
Rationale: Unexplained nosebleeds, waking to urinate at night (nocturia), and dizziness are symptoms associated with hypertension due to increased vascular pressure, kidney effects, and cerebral hypoperfusion, respectively.