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A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
- A. Blood pressure increased from 98/42 mm Hg to 112/50 mm Hg
- B. Respiratory rate decreased from 25 breaths/min to 14 breaths/min
- C. Oxygen saturation increased from 88% to 90%
- D. Pulse decreased from 100 beats/min to 80 beats/min
Correct Answer: D
Rationale: Beta blockers block the stimulation of beta-adrenergic receptors, reducing the sympathetic response and decreasing heart rate. A decrease in pulse from 100 beats/min to 80 beats/min is an expected effect of beta blockers, as they slow the heart rate and reduce cardiac output.
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An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
- A. I get short of breath when I climb stairs
- B. I see lights flashing in front of my eyes
- C. I have trouble remembering things
- D. I wake up to urinate multiple times at night
Correct Answer: A
Rationale: Dyspnea on exertion, such as shortness of breath when climbing stairs, is an early manifestation of heart failure due to reduced cardiac output during activity. The other symptoms are not specific to heart failure.
Where should the nurse auscultate the aortic valve?
- A. Location A: Second intercostal space, right of sternum
- B. Location B: Second intercostal space, left of sternum
- C. Location C: Fifth intercostal space, midclavicular line
- D. Location D: Fourth intercostal space, left of sternum
Correct Answer: A
Rationale: The aortic valve is best auscultated in the second intercostal space just to the right of the sternum, where heart sounds related to aortic flow are most audible.
A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. Which action should the nurse take?
- A. Elevate the leg and apply a sandbag to the entrance site
- B. Increase the flow rate of intravenous fluids
- C. Notify the provider immediately
- D. Document the finding as left pedal pulse of +1
Correct Answer: C
Rationale: A weak pedal pulse post-angiography may indicate arterial obstruction or hematoma formation, which is a serious complication. The nurse should notify the provider immediately for further evaluation and intervention.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
- A. An 80-year-old male with a history of asthma
- B. A 32-year-old Asian-American male with colorectal cancer
- C. A 45-year-old American Indian female with diabetes mellitus
- D. A 53-year-old postmenopausal woman who is on hormone therapy
Correct Answer: C
Rationale: The incidence of coronary artery disease and hypertension is higher in American Indians than in other populations. Diabetes mellitus further increases the risk for cardiovascular disease in any population, making the 45-year-old American Indian female with diabetes mellitus the client with the greatest risk.
A nurse prepares a client for coronary artery bypass graft surgery. The client states, 'I am afraid I might die.' How should the nurse respond?
- A. This is a routine surgery and the risk of death is very low
- B. Would you like to speak with a chaplain prior to surgery?
- C. Tell me more about your concerns about the surgery
- D. What support systems do you have to assist you?
Correct Answer: C
Rationale: The nurse should explore the client's fears by encouraging open discussion, which helps address concerns and provide emotional support. Dismissing fears, redirecting to a chaplain, or focusing on support systems does not directly address the client's stated concern.