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Having heard the observer's comment, which statement by the nurse would be most helpful for an untrained individual to remember if a trained individual is not present?
- A. An untrained person can always stay with the victim until help arrives.
- B. Do not worry about compressions; just breathe regularly in the mouth.
- C. Begin chest compressions in the center of the chest pressing down 2 inches (5 cm).
- D. Place the client flat and elevate the feet to promote circulation.
Correct Answer: C
Rationale: Untrained individuals can perform compression-only CPR, pressing 2 inches deep at 100-120 per minute.
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The nurse responds to the call light of a client who has a history of angina pectoris. He tells the nurse that he has just taken a nitroglycerin tablet sublingually for anginal pain. What action should the nurse take next?
- A. If the pain does not subside within five minutes, place a second tablet under his tongue
- B. Position him with head lower than feet
- C. Administer a narcotic as needed (PRN) for pain if he still has pain in 10 minutes
- D. Call his physician and alert the code team for possible intervention
Correct Answer: A
Rationale: If anginal pain persists five minutes after the first nitroglycerin tablet, a second tablet should be administered, with up to three doses at five-minute intervals. Positioning with head lower than feet, narcotics, or calling the physician are not the immediate next steps.
Which value should the nurse report immediately to the physician?
- A. Sodium: 137 mEq/L
- B. Potassium: 2.5 mEq/L
- C. Chloride: 97 mEq/L
- D. Bicarbonate: 25 mEq/L
Correct Answer: B
Rationale: Potassium of 2.5 mEq/L (hypokalemia) is critical, especially with diuretics, risking arrhythmias.
When the client asks the nurse how cholesterol acts as a cardiac risk factor, what is the best explanation?
- A. Excess fat in the blood expands the circulating blood volume.
- B. Excess fat in the blood thickens the lining of the arteries.
- C. Excess fat in the blood causes slower blood clotting.
- D. Excess fat in the blood stimulates the heart to beat faster.
Correct Answer: B
Rationale: High cholesterol contributes to atherosclerosis, where excess fat (lipids) deposits thicken and harden the arterial walls, narrowing the lumen and increasing cardiac risk.
The nurse is caring for a client who is being evaluated for arteriosclerosis obliterans. Which complaint is the client most likely to have?
- A. Burning pain in the legs that wakens him or her at night
- B. Numbness of the feet and ankles with exercise
- C. Leg pain while walking that becomes severe enough to force him or her to stop
- D. Increasing warmth and redness of the legs when they are elevated
Correct Answer: C
Rationale: Intermittent claudication, or leg pain during walking that resolves with rest, is the hallmark symptom of arteriosclerosis obliterans due to arterial insufficiency.
Digoxin (Lanoxin) and furosemide (Lasix) are ordered for a client who has congestive heart failure. Which of the following would the nurse also expect to be ordered for this client?
- A. Potassium
- B. Calcium
- C. Aspirin
- D. Coumadin
Correct Answer: A
Rationale: Furosemide, a diuretic, can cause potassium loss, leading to hypokalemia, which increases the risk of digoxin toxicity. Potassium supplements are often ordered to maintain normal levels.