Nokea
A patient is scheduled for exercise nuclear imaging stress testing. The nurse explains to the patient that this test involves
- A. IV administration of a radioisotope at the maximum heart rate during exercise to identify the heart's response to physical stress
- B. placement of electrodes inside the right-sided heart chambers through a vein to record the electrical activity of the heart directly
- C. exercising on a treadmill or stationary bicycle with continuous ECG monitoring to detect ischemic changes during exercise
- D. placement of a small transducer in four positions on the chest to record the direction and flow of blood through the heart by the reflection of sound waves
Correct Answer: A
Rationale: Nuclear imaging evaluates myocardial perfusion under stress.
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A child is scheduled for echocardiography. The nurse is providing teaching to the child's mother. Which statement by the mother about echocardiography indicates the need for further teaching?
- A. "I'm glad my child won't have an I.V catheter inserted for this procedure."
- B. "I'm glad my child won't need to have dye injected into him before the procedure."
- C. "How am I going to explain to my son that he can't have anything to eat before the test?"
- D. "I know my child may need to lie on his left side and breathe in and out slowly during the procedure."
Correct Answer: B
Rationale: The correct answer is B. Echocardiography does not typically require dye injection. This is known as a non-invasive imaging technique. Choice A is correct because an IV catheter is not usually needed for this procedure. Choice C is incorrect as fasting before the test is common practice to ensure accurate results. Choice D is correct as lying on the left side and breathing slowly helps with image quality. Therefore, choice B is the most appropriate answer as it reflects a misunderstanding of the procedure.
Diltiazem (Cardizem) is ordered for a patient with newly diagnosed Prinzmetal’s (variant) angina. When teaching the patient, the nurse will include the information that diltiazem will
- A. reduce heart palpitations.
- B. prevent coronary artery plaque.
- C. decrease coronary artery spasms.
- D. increase contractile force of the heart.
Correct Answer: C
Rationale: The correct answer is C: decrease coronary artery spasms. Diltiazem is a calcium channel blocker that helps to relax and dilate coronary arteries, reducing the frequency and severity of coronary artery spasms in Prinzmetal's angina. This action improves blood flow to the heart muscle, relieving chest pain.
A: reduce heart palpitations - Diltiazem may cause bradycardia (slow heart rate) but is not primarily used to reduce heart palpitations.
B: prevent coronary artery plaque - Diltiazem does not prevent the formation of coronary artery plaque.
D: increase contractile force of the heart - Diltiazem actually decreases the contractile force of the heart by reducing cardiac workload and oxygen demand.
The client is taking a class IB anti-arrhythmic drug. What drug might that be?
- A. Lidocaine
- B. Procainamide
- C. Mexiletine
- D. Metoprolol
Correct Answer: B
Rationale: Step-by-step rationale:
1. Class IB anti-arrhythmic drugs work by blocking sodium channels.
2. Procainamide is a Class IB anti-arrhythmic drug.
3. Lidocaine (A) is a Class IB anti-arrhythmic drug but more commonly used for acute arrhythmias.
4. Mexiletine (C) is a Class IB anti-arrhythmic drug but less commonly used.
5. Metoprolol (D) is a beta-blocker (Class II) used for other cardiac conditions.
In summary, Procainamide is the correct choice as it belongs to the Class IB anti-arrhythmic drugs, while the other options are either less common in this class or belong to different drug classes.
The client is on a cardio-selective beta blocker. Why might this be ordered?
- A. The client cannot have blockage to the beta receptors in the blood vessels.
- B. The client needs a cardio-selective drug because of hypotension in non-cardio-selective beta blockers.
- C. The client has asthma that would be exacerbated by a non- cardio-selective beta blocker.
- D. The client has hypoglycemia that would be worsened with a non-cardio-selective beta blocker.
Correct Answer: C
Rationale: The correct answer is C because a client with asthma would be at risk of bronchoconstriction if given a non-cardio-selective beta blocker. Cardio-selective beta blockers primarily target beta-1 receptors in the heart, sparing beta-2 receptors in the lungs. This reduces the risk of bronchoconstriction in clients with asthma. Choices A, B, and D are incorrect because they do not address the specific concern of bronchoconstriction in clients with asthma. Answer A refers to blood vessel blockage, which is not the primary concern in this scenario. Answer B mentions hypotension, which is not directly related to the risk of bronchoconstriction in asthma. Answer D discusses hypoglycemia, which is not a primary concern with beta blockers in asthma management.
In providing community education on prevention of peripheral arterial disease, the nurse is careful to include which of the following as a major risk factor?
- A. Dysrhythmias
- B. Low-protein intake
- C. Exposure to cool weather
- D. Cigarette smoking
Correct Answer: D
Rationale: The correct answer is D: Cigarette smoking. Smoking is a major risk factor for peripheral arterial disease as it narrows and damages blood vessels, leading to reduced blood flow. This can result in serious complications such as leg pain, poor wound healing, and even amputation. Dysrhythmias (A) are heart rhythm abnormalities and not directly linked to peripheral arterial disease. Low-protein intake (B) is not a known risk factor for peripheral arterial disease. Exposure to cool weather (C) may exacerbate symptoms in individuals with peripheral arterial disease, but it is not a major risk factor for developing the condition.