Nokea
A prothrombin time test should be performed regularly on persons who are taking which medication?
- A. Heparin
- B. Warfarin
- C. Phenobarbital
- D. Digoxin
Correct Answer: B
Rationale: A prothrombin time test is done to determine the effectiveness of warfarin. A partial thromboplastin time test is used for heparin. Phenobarbital and digoxin do not require regular clotting tests, though serum levels may be monitored for long-term therapy.
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Which assessment finding is most closely correlated with an evolving MI?
- A. Nausea
- B. Facial flushing
- C. Severe headache
- D. Coughing up pink-tinged mucus
Correct Answer: A
Rationale: Nausea is a common symptom of myocardial infarction due to vagal stimulation or pain-induced stress response.
Avoiding which of the following foods is the best evidence that the client understands the nurse's dietary instructions?
- A. Pepperoni pizza
- B. Vinegar and oil salad dressing
- C. Liver and onions
- D. Lemon-pepper chicken
Correct Answer: A
Rationale: Pepperoni pizza is high in fat and sodium, which should be avoided in a low-fat, low-sodium diet post-MI.
If the client understands the nurse's explanation of the heart's conduction system, which structure will the client identify as the site of the natural pacemaker? Place an X over the correct site.
- A. Sinoatrial node
- B. Atrioventricular node
- C. Bundle of His
- D. Purkinje fibers
Correct Answer: A
Rationale: The sinoatrial (SA) node is the heart's natural pacemaker, initiating electrical impulses.
The nurse is caring for an elderly client who has congestive heart failure and is taking digoxin. The client should be monitored for which of the following signs of toxicity?
- A. Disorientation
- B. Weight gain
- C. Constipation
- D. Dyspnea
Correct Answer: A
Rationale: Disorientation is a neurological sign of digoxin toxicity. Weight gain, constipation, and dyspnea are not specific to digoxin toxicity.
The client tells the nurse of being extremely frightened. What is the most appropriate action for the nurse to take at this time?
- A. Stay with the client.
- B. Explain the procedures.
- C. Tell the client it will be fine.
- D. Record the collected data.
Correct Answer: A
Rationale: Staying with the client provides emotional support, reducing fear during a crisis.