Nokea
Delegation Decision: The unit is very busy and short staffed. What could be delegated to the unlicensed assistive personnel (UAP)?
- A. Administer antihypertensive medications to stable patients
- B. Obtain orthostatic blood pressure (BP) readings for older patients
- C. Check BP readings for the patient receiving IV enalapril (Vasotec)
- D. Teach about home BP monitoring and use of automatic BP monitoring equipment
Correct Answer: B
Rationale: UAPs can perform routine tasks like orthostatic BP checks.
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A client comes to the clinic and states he has a history of hypertension. Which type of medication might the nurse expect the client to be taking to control his blood pressure?
- A. Antilipemics
- B. Antibiotics
- C. ACE inhibitors
- D. Antidiabetics
Correct Answer: C
Rationale: Step 1: ACE inhibitors are commonly prescribed for hypertension as they help relax blood vessels, lowering blood pressure.
Step 2: Antilipemics are for lowering cholesterol, not blood pressure.
Step 3: Antibiotics are for infections, not hypertension.
Step 4: Antidiabetics are for managing blood sugar levels, not blood pressure.
Summary: Choice C is correct as ACE inhibitors are specifically used to manage hypertension by lowering blood pressure. Choices A, B, and D are incorrect as they are used for different purposes unrelated to hypertension.
The nurse explains to the patient who is to undergo a coronary artery bypass graft that the procedure most often involves
- A. Using a synthetic graft as a tube for blood flow from the aorta to a coronary artery distal to an obstruction
- B. Resecting a stenosed coronary artery and inserting a synthetic arterial tube graft to replace the diseased artery
- C. Loosening the internal mammary artery from the chest wall and attaching it to a coronary artery distal to a stenosis
- D. Anastomosing reversed segments of a saphenous vein from the aorta to the coronary artery distal to an obstruction
Correct Answer: C
Rationale: The most common method of coronary artery bypass involves leaving the internal mammary artery attached to its origin from the subclavian artery but dissecting it from the chest wall and anastomosing it distal to an obstruction in a coronary artery.
Which of the following does Mr. Brown need to understand regarding coronary bypass surgery?
- A. There are no alternatives to bypass surgery
- B. The postoperative mortality is high
- C. Bypass surgery is his best chance for cure of his disease process
- D. Coronary bypass surgery is a prophylactic measure
Correct Answer: C
Rationale: Bypass surgery aims to restore blood flow and improve outcomes.
The registered nurse has finished reviewing the 7:00 a.m shift report on a telemetry unit. Which of the following clients would be the best for the RN to assign to the licensed practical nurse?
- A. A 7-day postoperative CABG client with an infection in the sternal surgical incision, requiring dressings and irrigation.
- B. A client who has just arrived on the unit from the emergency room for observation to rule out a myocardial infarction.
- C. A client who has had successful valve replacement therapy and will be discharged this morning.
- D. A client who is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) at 10:00 a.m.
Correct Answer: A
Rationale: The correct answer is A because the 7-day postoperative CABG client with an infection in the sternal surgical incision requires ongoing wound care, dressings, and irrigation, which are within the scope of practice for a licensed practical nurse.
Choice B is incorrect because a client who has just arrived from the emergency room for observation to rule out a myocardial infarction may require immediate assessment and interventions beyond the scope of a licensed practical nurse.
Choice C is incorrect because a client who has had successful valve replacement therapy and will be discharged this morning may require coordination of care, discharge teaching, and documentation, which are typically the responsibilities of a registered nurse.
Choice D is incorrect because a client scheduled for a percutaneous transluminal coronary angioplasty at 10:00 a.m may require pre-procedure preparations, monitoring, and post-procedure care that are best handled by a registered nurse.
When caring for a patient who is recovering from a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction (AMI), the nurse will anticipate teaching the patient that
- A. sudden cardiac death events rarely reoccur.
- B. additional diagnostic testing will be required.
- C. long-term anticoagulation therapy will be needed.
- D. limiting physical activity will prevent future SCD events.
Correct Answer: B
Rationale: Step 1: Sudden cardiac death (SCD) indicates a serious underlying heart condition.
Step 2: Absence of acute myocardial infarction (AMI) suggests other causes need investigation.
Step 3: Additional diagnostic testing can identify underlying causes to prevent future events.
Step 4: Teaching the patient about the need for further testing is crucial for proper management.
Summary: Option B is correct as it aligns with the need for comprehensive evaluation post-SCD. Options A, C, and D are incorrect as they do not address the necessity of additional testing for proper management.