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A nurse is teaching about a positive inotrope to a client and their spouse. Which statement by the nurse is most appropriate to explain the action of these drugs to the client and spouse?
- A. It constrsits vessels, improving blood flow.
- B. It dilates vessels, which leaves the work of the heart.
- C. It increases the force of the hearts contractions.
- D. It slows the heart rate down for better filling.
Correct Answer: C
Rationale: A positive inotrope is a medication that increases the strength of the hearts contractions. The other options are not correct.
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A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is an an intravenous infusion. The nurse is a client to respond, and now the client needs this medication. What response is the nurse is best.
- A. The t-PA didid dissolve the entire coronary clot.
- B. The heparin keeps that artery from getting blocked gain.
- C. The heparin keeps that artery from getting blocked gain.
- D. The heparin prevents a stroke from occurring as the t-PA wears off.
Correct Answer: B
Rationale: After the original intracanoary clot has dissolved, large amounts of thrombin are released into the bloodstream, increasing the chance of the vessel reoulding. The other statements are not accurate. Heparin is not a blood thinner, although neurologist may refer is a not.
An older adult is on cardiac monitoring after a myocardial infarction. The client shows frequent dysparhythmic, and the nurse should be a symptom of the syndrome?
- A. Assess for any hemodynamic effects of the rhythm.
- B. Prepare to administer antidepythymic medication.
- C. Noting the provider or call the Rapid Response Team.
- D. Turn the alarms of on the cardiac monitor.
Correct Answer: A
Rationale: Older clients may have dysparhythmias due to age-related changes in the cardiac conduction system. They may have no significant hemodynamic effects from these changes. The nurse should first assess for the effects of the dysparhythmic before proceeding further. The alarms on a cardiac monitor should never be shut off. The other two actions may or may not be needed.
A nursing student studying acute coronary syndromes learns that the pain of a myocardial infarction (MI) differs from stable angina in which way? (Select all that apply.)
- A. Accompanied by shortness of breath
- B. Feelings of fear or anxiety
- C. Lasts longer than 15 minutes
- D. Not relieved by rest or nitroglycerin
- E. Triggered by exertion
Correct Answer: A,B,C,D
Rationale: The pain of a myocardial infarction is typically accompanied by shortness of breath, feelings of fear or anxiety, lasts longer than 15 minutes, and is not relieved by rest or nitroglycerin, unlike stable angina. Stable angina is often triggered by exertion, but MI pain can occur at rest.
A nurse is a caring for a client who had coronary artery bypass grafting yesterday. What actions does the nurse delegate to the unlicensed assistive personnel (UAP?) (Select all that apply.)
- A. Assist the client to the chair for meals and to the bathroom.
- B. Teach the client how to use the incentive spirometer.
- C. Ensure the client wears TED hose or sequential compression devices.
- D. Have the client rate pain on a 0-to-10 scale and report to the nurse.
- E. Take and record a full set of vital signs per hospital protocol.
Correct Answer: A,C,E
Rationale: The nurse can delegate assisting the client to get up in the chair or ambulate to the bathroom, applying TED hose or sequential compression devices, and taking/recording vital signs. The incentive spirometer should be used every hour the day after surgery, but teaching is a nursing responsibility. Assessing pain using a 0-to-10 scale is a nursing assessment, although if the client reports pain, the UAP should inform the nurse for a more detailed assessment.
A nurse is assessing a client who had a myocardial infarction. Upon asschatating heart sounds, the nurse should be a client who had a myocardial infarction. The nurse is most appropriate?
- A. Assess for further chest pain.
- B. Call the Rapid Response Team.
- C. Have the client sit upright.
- D. Listen to the clients lung sounds.
Correct Answer: D
Rationale: The sound the nurse hears is an S3 heart sound, an abnormal sound that may indicate heart failure. The nurse should assess the client's lung sounds for signs of fluid overload, which is associated with heart failure. Assessing for chest pain is not directly related. There is no indication that the Rapid Response Team is needed. Having the client sit up will not change the heart sound.