Nokea
If Mr. Jones has a demand pacemaker implanted, the nurse instructs Mr. Jones that he should notify the physician if he experiences
- A. A change in pulse rate of three beats per minute
- B. A sudden slowing or increasing of pulse
- C. An irregular pulse rate
- D. Exposure to an electric razor
Correct Answer: C
Rationale: Irregular pulse indicates potential pacemaker malfunction.
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The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?
- A. Take the medication with food to prevent stomach upset.
- B. Do not miss a dose and take it at the same time each day.
- C. Avoid consuming alcohol while on this medication.
- D. Monitor for signs of bleeding.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Dabigatran is an anticoagulant used to prevent blood clots.
2. Consistent dosing is crucial to maintain therapeutic levels.
3. Missing doses increases the risk of clot formation.
4. Taking it at the same time daily helps to ensure effectiveness.
Summary:
A: Taking with food is not essential for dabigatran.
C: Alcohol does not directly interact with dabigatran.
D: Monitoring for bleeding is important, but consistent dosing is the priority for efficacy.
Mr. Ross experiences nausea and vomiting as the result of receiving large-volume irradiation to his thoracic region. Which is the best approach in planning to meet his nutritional needs?
- A. Plan for frequent small meals of palatable foods
- B. Offer Mr. Ross three balanced meals a day
- C. Determine Mr. Ross' caloric needs
- D. Ask the physician to prescribe an oral antiemetic for p.r.n. use
Correct Answer: A
Rationale: Frequent small meals can help manage nausea and improve intake compared to large meals.
Which condition is characterized by the right ventricle of the heart failing due to increased pressure in the lungs, often caused by chronic lung disease?
- A. Cor pulmonale
- B. Pulmonary embolism
- C. Aortic stenosis
- D. Hypertrophic cardiomyopathy
Correct Answer: A
Rationale: The correct answer is A: Cor pulmonale. This condition is characterized by right ventricle failure due to increased pulmonary pressure from chronic lung disease. Step 1: Chronic lung disease causes increased pressure in the lungs. Step 2: The increased pressure in the lungs leads to the right ventricle of the heart working harder to pump blood through the lungs. Step 3: Over time, this increased workload can cause right ventricular failure, known as cor pulmonale. Summary: B is incorrect as pulmonary embolism is a sudden blockage of an artery in the lungs. C is incorrect as aortic stenosis involves narrowing of the aortic valve, affecting the left ventricle. D is incorrect as hypertrophic cardiomyopathy is a genetic condition causing thickening of the heart muscle.
The client on nitroglycerin complains of a headache. What is the most appropriate response by the nurse?
- A. Administer acetaminophen as prescribed for the headache.
- B. Hold the next dose of nitroglycerin.
- C. Discontinue the nitroglycerin immediately.
- D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: The correct response is to administer acetaminophen as prescribed for the headache. This is because headaches are a common side effect of nitroglycerin due to vasodilation. Acetaminophen can help relieve the headache without interfering with the therapeutic effects of nitroglycerin. Holding the next dose (B) is not appropriate as it can lead to inadequate treatment of the client's condition. Discontinuing nitroglycerin (C) abruptly can be dangerous as it may cause rebound hypertension. Notifying the healthcare provider (D) is not necessary unless the headache persists or worsens.
Which condition is characterized by the sudden onset of shortness of breath, often occurring at night and associated with heart failure?
- A. Paroxysmal nocturnal dyspnea
- B. Sleep apnea
- C. Orthopnea
- D. Dyspnea
Correct Answer: A
Rationale: The correct answer is A: Paroxysmal nocturnal dyspnea. This condition is characterized by sudden onset of shortness of breath at night, often associated with heart failure. It occurs when a person lies down due to fluid redistribution in the body, leading to increased pressure on the lungs and heart. Sleep apnea (B) is a separate condition characterized by pauses in breathing during sleep. Orthopnea (C) is difficulty breathing while lying flat, relieved by sitting up. Dyspnea (D) is a general term for shortness of breath but does not specifically refer to the sudden onset at night associated with heart failure.