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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.
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A nurse obtains the health history of a client who is newly admitted to the medical unit. Which statement by the client should alert the nurse to the presence of edema?
- A. I wake up to go to the bathroom at night
- B. My shoes fit tighter by the end of the day
- C. I drink at least eight glasses of water a day
- D. I have gained 5 pounds in the last month
Correct Answer: B
Rationale: Edema is characterized by fluid accumulation in interstitial spaces, often causing swelling that makes shoes or clothing feel tighter, especially at the end of the day. This symptom is indicative of edema, unlike the other options.
An emergency department nurse triages clients who present with chest discomfort. Which client should the nurse plan to assess first?
- A. A 30-year-old female who describes her pain as a dull ache with numbness in her fingers
- B. A 40-year-old male who reports moderate pain that is worse on inspiration
- C. A 53-year-old female who reports substantial pain that radiates to her abdomen
- D. A 36-year-old female who reports substantial pain that radiates to her jaw
Correct Answer: D
Rationale: Substantial chest pain radiating to the jaw is a classic symptom of myocardial infarction, requiring immediate assessment. Pain described as dull, related to inspiration, or radiating to the abdomen is less specific for acute cardiac events.
A nurse monitors a client 2 hours after a cardiac catheterization. Which findings would require immediate action? (Select all that apply.)
- A. Blood pressure of 142/88 mm Hg
- B. Serum potassium of 2.9 mEq/L
- C. Warmth and redness at the site
- D. Expanding hematoma
- E. Rhythm changes on the cardiac monitor
Correct Answer: B,D,E
Rationale: Hypokalemia (2.9 mEq/L), an expanding hematoma, and rhythm changes are serious complications requiring immediate action. Slightly elevated blood pressure and warmth/redness (if not severe) are less urgent in the immediate post-procedure period.
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.
A nurse prepares a client with acute renal insufficiency for a cardiac catheterization. The provider prescribes 0.9% normal saline to infuse at 125 mL/h for renal protection. The nurse obtains gravity tubing with a drip rate of 15 drops/mL. At what rate (drops/min) should the nurse infuse the fluids?
- A. 30 drops/min
- B. 31 drops/min
- C. 32 drops/min
- D. 33 drops/min
Correct Answer: B
Rationale: To calculate the drip rate: (125 mL/h ? 15 drops/mL) ÷ 60 min/h = 31.25 drops/min. Rounding to the nearest whole number gives 31 drops/min.