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A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting. Which cause of the patient's symptoms would the nurse suspect?
- A. Spasm of a major coronary artery.
- B. Exposure of the thrombogenic surface to plaque.
- C. Myocardial ischemia due to coronary artery disease.
- D. Myocardial ischemia secondary to microvascular disease.
Correct Answer: C
Rationale: Myocardial ischemia due to coronary artery disease causes chest pain provoked by exertion and relieved by rest, characteristic of stable angina.
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A patient's blood pressure (BP) reading is 142/91 mm Hg. How would the nurse classify the BP?
- A. Normal.
- B. Prehypertension.
- C. Hypertension, stage 1.
- D. Hypertension, stage 2.
Correct Answer: C
Rationale: A BP of 142/91 mm Hg is classified as stage 1 hypertension, with systolic 140-159 mm Hg or diastolic 90-99 mm Hg.
Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?
- A. 0.459% saline.
- B. 0.9% NaCl.
- C. 5% dextrose in 0.45% saline.
- D. Dextran.
Correct Answer: B
Rationale: 0.9% NaCl (normal saline) is an isotonic solution ideal for hypovolemic shock, expanding intravascular volume without causing fluid shifts.
The nurse provides education to a patient about the symptoms of uncontrolled hypertension. Which symptom would the nurse include? Select all that apply.
- A. Fatigue.
- B. Dizziness.
- C. Palpitations.
- D. Cluster headaches.
Correct Answer: A,B,C
Rationale: Fatigue, dizziness, and palpitations are symptoms of uncontrolled hypertension due to cardiovascular strain and vascular effects; cluster headaches are not directly related.
A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: Respiratory acidosis is characterized by low pH (7.32) and high PaCO2 (56 mm Hg), with normal HCO3 indicating no metabolic compensation.
The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
- A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.
- B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.
- C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.
- D. Sodium level of 144 mEq/L, potassium level of 3.7 PROTOCOL mEq/L.
Correct Answer: C
Rationale: Normal sodium (135 mEq/L) and potassium (3.6 mEq/L) levels support changing to a lower potassium IV (20 mEq KCl/L) to prevent hyperkalemia while maintaining hydration.