Nokea
A male client with heart failure (HF) calls the clinic and reports that he cannot put his shoes on because they are too tight. Which additional information should the nurse obtain?
- A. What time did he take his last medications?
- B. Has his weight changed in the last several days?
- C. Is he still able to tighten his belt buckle?
- D. How many hours did he sleep last night?
Correct Answer: B
Rationale: Weight gain is a key indicator of fluid retention in heart failure, which can exacerbate symptoms.
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Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
Prior to the patient being given medication, he becomes hypotensive, mottled, and cold. His heart rate is 240. The next therapeutic step should be
- A. digoxin
- B. synchronized DC cardioversion
- C. lidocaine
- D. defibrillation
Correct Answer: B
Rationale: Synchronized DC cardioversion is indicated for unstable tachycardia unresponsive to pharmacological agents.
An adolescent female has a history of repaired tetralogy of Fallot (TOF). Which long-term complication is a concern for this patient?
- A. Aortic stenosis
- B. Chronic cyanosis
- C. Mitral valve prolapse
- D. Ventricular failure
Correct Answer: C
Rationale: Patients with repaired TOF, especially adolescent females, are at risk for mitral valve prolapse.
The nurse is preparing to administer enoxaparin (Lovenox) 135 mg subcutaneously. The medication is available in a cartridge labeled 150 mg/ml. How many ml should the nurse administer? (enter numeric value only. If rounding is required, round to the nearest tenth.)
- A. 0.9
- B. 1
- C. 9
Correct Answer: A
Rationale: The calculation is based on the prescribed dose and the concentration of the medication.
The healthcare provider prescribes epoetin alfa (Procrit) 8,200 units subcutaneously for a client with chronic kidney disease (CKD). The 2 ml multidose vial is labeled, 'Each 1 ml of solution contains 10,000 units of epoetin alfa.' How many ml should the nurse administer?
- A. 0.8
- B. 8
- D. 1
Correct Answer: A
Rationale: To calculate the dose, the nurse must divide the prescribed dose (8,200 units) by the concentration (10,000 units per ml). 8,200 ÷ 10,000 = 0.82 ml, rounded to 0.8 ml.