Nokea
A young adult with a history of rheumatic fever as a child is to have a cardiac catheterization. She asks the nurse why she must have a cardiac catheterization. The nurse's response is based on the understanding that cardiac catheterization can accomplish all of the following EXCEPT:
- A. assessing heart structures.
- B. determining oxygen levels in the heart chambers.
- C. evaluating cardiac output.
- D. obtaining a biopsy specimen.
Correct Answer: D
Rationale: Cardiac catheterization can assess heart structures, measure oxygen levels, and evaluate cardiac output, but obtaining a biopsy specimen is not a standard purpose of this procedure. Biopsies are typically performed via other methods, such as endomyocardial biopsy in specific cases.
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The client diagnosed with a myocardial infarction is six (6) hours post-right femoral percutaneous transluminal coronary angioplasty (PTCA), also known as balloon surgery. Which assessment data would require immediate intervention by the nurse?
- A. The client is keeping the affected extremity straight.
- B. The pressure dressing to the right femoral area is intact.
- C. The client is complaining of numbness in the right foot.
- D. The client's right pedal pulse is 3+ and bounding.
Correct Answer: C
Rationale: Numbness (C) suggests vascular compromise or nerve compression, requiring immediate intervention. Keeping the leg straight (A), intact dressing (B), and strong pulse (D) are expected.
If the client's pain is due to a myocardial infarction (MI), which prescribed medication would be most helpful?
- A. A nonsteroidal anti-inflammatory drug such as ibuprofen (Advil)
- B. A nonsalicylate such as acetaminophen (Tylenol)
- C. A salicylate such as aspirin
- D. An opioid such as morphine sulfate
Correct Answer: C
Rationale: Aspirin is critical in MI to inhibit platelet aggregation and prevent further thrombus formation.
When providing dietary instructions for this client, which healthful alternative should the nurse recommend?
- A. Wheat toast for white bread
- B. Margarine for butter
- C. Cereal for eggs
- D. Ham for sausage
Correct Answer: C
Rationale: Cereal is a low-cholesterol, heart-healthy alternative to eggs, which are high in cholesterol. Wheat toast and margarine still contain some fats, and ham is high in sodium and fat.
The telemetry nurse notes a peaked T wave for the client diagnosed with congestive heart failure. Which laboratory data should the nurse assess?
- A. CK-MB.
- B. Troponin.
- C. BNP.
- D. Potassium.
Correct Answer: D
Rationale: Peaked T waves indicate hyperkalemia; assessing potassium (D) is critical in CHF patients on diuretics. CK-MB (A) and troponin (B) are for MI, BNP (C) for heart failure severity.
The client is exhibiting ventricular tachycardia. Which intervention should the nurse implement first?
- A. Administer amiodarone, an antidysrhythmic, IVP.
- B. Prepare to defibrillate the client.
- C. Assess the client's apical pulse and blood pressure.
- D. Start basic cardiopulmonary resuscitation.
Correct Answer: C
Rationale: Ventricular tachycardia requires assessing pulse/BP (C) to determine if it’s pulseless (defibrillation, B) or stable (amiodarone, A). CPR (D) is for pulseless states.