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A nurse prepares a client for a pharmacologic stress echocardiogram. Which actionsadalafil should the nurse take when preparing this client for the procedure? (Select all that apply.)
- A. Obtain peripheral venous access
- B. Prepare for continuous blood pressure and pulse monitoring
- C. Administer the client's prescribed beta blocker
- D. Give the client nothing by mouth 3 to 6 hours before the procedure
- E. Explain to the client that dobutamine will simulate exercise for this examination
Correct Answer: A,B,D,E
Rationale: For a pharmacologic stress echocardiogram, the nurse should obtain IV access, monitor blood pressure and pulse continuously, ensure the client is NPO for 3-6 hours, and educate about dobutamine's role in simulating exercise. Beta blockers are typically held to avoid interference with the stress test.
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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.
A nurse reviews a client's laboratory results. Which findings should alert the nurse to the possibility of atherosclerosis? (Select all that apply.)
- A. Total cholesterol: 280 mg/dL
- B. High-density lipoprotein cholesterol: 50 mg/dL
- C. Triglycerides: 200 mg/dL
- D. Serum albumin: 4 g/dL
- E. High-density lipoprotein cholesterol: 30 mg/dL
Correct Answer: A,C,E
Rationale: Elevated total cholesterol (280 mg/dL), elevated triglycerides (200 mg/dL), and low high-density lipoprotein cholesterol (30 mg/dL) are associated with increased risk of atherosclerosis. Serum albumin is not related to atherosclerosis risk, and an HDL of 50 mg/dL is within normal limits.
A nurse assesses an older adult client who has multiple chronic diseases. The client's heart rate is 48 beats/min. Which action should the nurse take first?
- A. Document the finding in the chart
- B. Initiate external pacing
- C. Assess the client's medications
- D. Administer 1 mg of atropine
Correct Answer: C
Rationale: Bradycardia in older adults can result from a decrease in pacemaker cells or medication effects. The nurse should first assess the client's medications, as certain drugs (e.g., beta blockers) can cause a low heart rate. This step precedes documentation, pacing, or administering atropine.
A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition should the nurse include in this client's teaching?
- A. The best way to lose weight is a high-protein, low-carbohydrate diet
- B. Follow the American Heart Association guidelines for nutrition
- C. A nutritionist will provide you with information about your new diet
- D. If you exercise more frequently, you won't need to change your diet
Correct Answer: B
Rationale: Clients at high risk for coronary artery disease should follow the American Heart Association guidelines, which emphasize a balanced diet low in saturated fats and high in fruits, vegetables, and whole grains to reduce cardiovascular risk.
A nurse assesses an older adult client who is experiencing a myocardial infarction. Which clinical manifestation should the nurse expect?
- A. Excruciating pain on inspiration
- B. Left lateral chest wall pain
- C. Disorientation or confusion
- D. Numbness and tingling of the arm
Correct Answer: C
Rationale: In older adults, myocardial infarction may present with atypical symptoms such as disorientation or confusion due to poor cardiac output and reduced cerebral perfusion. While pain or numbness may occur, confusion is a critical manifestation in this population.