Nokea
An adult male had a myocardial infarction six weeks ago. He asks the nurse if it is safe for him to have sex. What should the nurse include when replying?
- A. Taking nitroglycerin before sexual activity is often helpful.
- B. Taking drugs for erectile dysfunction in addition to nitroglycerin is advised.
- C. The client should rest for several hours before engaging in sexual activity.
- D. Sexual activity should be avoided for six months after a heart attack.
Correct Answer: A
Rationale: Nitroglycerin before sexual activity can prevent angina, and sexual activity is generally safe 6 weeks post-MI if the patient is stable.
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The nurse is teaching a client about the toxicity of digoxin. Which one of the following statements made by the client to the nurse indicates more teaching is needed?
- A. I may experience a loss of appetite.'
- B. I can expect occasional double vision.'
- C. Nausea and vomiting may last a few days.'
- D. I must report a bounding pulse of 62 immediately.'
Correct Answer: D
Rationale: Slow heart rate is related to increased cardiac output and an intended effect of digoxin. The ideal heart rate is above 60 BPM with digoxin. The client needs further teaching.
A nurse is caring for a 2 year-old child after corrective surgery for Tetralogy of Fallot. The mother reports that the child has suddenly begun seizing. The nurse recognizes this problem is probably due to
- A. A cerebral vascular accident
- B. Postoperative meningitis
- C. Medication reaction
- D. Metabolic alkalosis
Correct Answer: A
Rationale: A cerebral vascular accident. Polycythemia occurs as a physiological reaction to chronic hypoxemia, increasing the risk of thromboembolic events like cerebrovascular accidents, which can manifest as seizures.
Which of the following medication orders needs further clarification?
- A. Darvocet (propoxyphene/acetaminophen) $65 \mathrm{mg} \mathrm{q} \mathrm{4-6} \mathrm{hr} \mathrm{PRN}$
- B. Nembutal (pentobarbital) $100 \mathrm{mg}$ at bedtime
- C. Coumadin (sodium warfarin) $10 \mathrm{mg}$
- D. Estrace (estradiol) $2 \mathrm{mg}$ q day
Correct Answer: C
Rationale: Coumadin 10 mg lacks a route (e.g., oral) and frequency, requiring clarification. Darvocet , Nembutal , and Estrace are complete orders.
A nurse is caring for a 37-year-old woman with metastatic ovarian cancer admitted for nausea and vomiting.
- A. What is the best indication that the nutritional status of a woman with metastatic ovarian cancer has improved after 4 days of TPN?
- B. The patient eats most of the food served to her.
- C. The patient has gained 1 pound since admission.
- D. The patient’s albumin level is 0 mg/dL.
- E. The patient’s hemoglobin is 8.5 g/dL.
Correct Answer: C
Rationale: Albumin levels (normal 5–5.0 g/dL) are the best indicator of long-term nutritional status, reflecting protein stores. A level of 0 mg/dL indicates improved nutrition. Eating more, weight gain (which may be fluid), or hemoglobin levels (affected by cancer or chemotherapy) are less reliable indicators.
A 30-year-old woman is receiving levothyroxine sodium (Synthroid) 0.1 mg PO daily.
Which of the following findings would indicate to the nurse that the client is getting favorable results from the medication?
- A. Decreased blood pressure.
- B. Increased urine output.
- C. Decreased pulse rate.
- D. Increased respiratory rate.
Correct Answer: B
Rationale: Strategy: Determine how each answer choice relates to hypothyroidism. (1) characteristic of hypothyroidism, would indicate that medication is not working (2) correct-medication increases metabolic processes of body, including glomerular filtration, edema will decrease as water is excreted (3) characteristic of hypothyroidism, would indicate that medication is not working (4) respiratory rate may or may not be affected by medication