Nokea
A patient with cardiogenic shock receives a nursing diagnosis of decreased cardiac output. With the appropriate interventions, the anticipated outcome is for the patient to achieve:
- A. baseline activity level.
- B. baseline cardiac function.
- C. decreased afterload.
- D. reduced anxiety.
Correct Answer: B
Rationale: Restoring baseline cardiac function is the goal in managing decreased cardiac output.
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The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?
- A. Dry cough
- B. Hypotension
- C. Hyperkalemia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Dry cough. Enalapril is an ACE inhibitor, which commonly causes a dry cough due to increased bradykinin levels. This side effect is well-documented in literature and can lead to medication non-adherence. Other choices (B) Hypotension, (C) Hyperkalemia, and (D) Headache are potential side effects of enalapril but are not as commonly associated as dry cough. Hypotension and hyperkalemia are more serious adverse effects that require monitoring, while headache is a less common side effect compared to dry cough.
What is the procedure where a catheter is used to open a blocked or narrowed coronary artery, often involving the placement of a stent?
- A. Angioplasty
- B. Valve replacement
- C. Stent placement
- D. Coronary artery bypass graft (CABG)
Correct Answer: A
Rationale: The correct answer is A: Angioplasty. During angioplasty, a catheter with a balloon at its tip is used to open a blocked or narrowed coronary artery. The balloon is inflated to widen the artery and improve blood flow. Often, a stent is placed during the procedure to help keep the artery open. Option B, valve replacement, is incorrect as it involves replacing a faulty heart valve, not opening a blocked coronary artery. Option C, stent placement, is close but not specific to the procedure of using a catheter and balloon. Option D, CABG, is a surgical procedure where arteries or veins are used to bypass blocked coronary arteries, not using a catheter.
The client is being taught about the use of warfarin. What is the most important dietary instruction?
- A. Avoid foods high in vitamin K.
- B. Increase the intake of vitamin K-rich foods.
- C. Avoid foods high in protein.
- D. Increase the intake of foods high in calcium.
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Consuming foods high in vitamin K can interfere with the effectiveness of warfarin. By avoiding these foods, the client can maintain consistent levels of the medication in their system.
Choice B is incorrect as increasing vitamin K-rich foods can counteract the effects of warfarin. Choice C is incorrect as there is no need to avoid foods high in protein when taking warfarin. Choice D is incorrect as increasing calcium intake does not have a direct impact on warfarin therapy.
The healthcare provider is monitoring a client on an ACE inhibitor. What lab value is most important to monitor?
- A. Potassium
- B. Sodium
- C. Creatinine
- D. Calcium
Correct Answer: A
Rationale: The correct answer is A: Potassium. ACE inhibitors can cause hyperkalemia, so monitoring potassium levels is crucial to prevent potential life-threatening complications. High potassium levels can lead to cardiac arrhythmias. Sodium levels are not typically affected by ACE inhibitors. Creatinine is important to monitor for kidney function but not specific to ACE inhibitors. Calcium levels are not directly affected by ACE inhibitors.
What is a blood clot that forms in a vein, often in the legs, and can cause serious complications if it travels to the lungs?
- A. Deep vein thrombosis (DVT)
- B. Pulmonary embolism
- C. Varicose veins
- D. Atherosclerosis
Correct Answer: A
Rationale: The correct answer is A: Deep vein thrombosis (DVT). DVT is a blood clot that forms in a deep vein, commonly in the legs. It can lead to serious complications if the clot dislodges and travels to the lungs, causing a pulmonary embolism. Varicose veins (C) are enlarged, twisted veins near the surface of the skin, not involving deep veins. Atherosclerosis (D) is the build-up of plaque in arteries, not related to vein clot formation. Pulmonary embolism (B) is a complication of DVT, not the initial clot formation in a vein.