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If the chest pain is not relieved after taking one nitroglycerin tablet, the nurse should teach the client to take what action?
- A. Take another tablet in 5 minutes.
- B. The nurse is the energy department.
- C. Call the physician immediately.
- D. Swallow two additional tablets.
Correct Answer: A
Rationale: If angina persists after one nitroglycerin tablet, another can be taken every 5 minutes up to three doses, then seek medical help if unrelieved.
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When the client asks the nurse how propranolol helps to prevent angina, what is the best explanation?
- A. Propranolol promotes excretion of body fluid.
- B. Propranolol reduces the rate of heart contraction.
- C. Propranolol alters pain receptors in the heart.
- D. Propranolol dilates the major coronary arteries.
Correct Answer: B
Rationale: Propranolol, a beta-blocker, reduces heart rate and contractility, decreasing myocardial oxygen demand and preventing angina.
When auscultating the client's heart and breath sounds during a routine shift assessment, which action by the nurse is most appropriate?
- A. Asking the client to hold the breath
- B. Using the bell of the stethoscope
- C. Positioning the client flat in bed
- D. Locating the xiphoid process
Correct Answer: B
Rationale: The bell of the stethoscope is best for low-pitched heart sounds in pericarditis.
The nurse is observing a client who is learning to perform Buerger-Allen exercises. The nurse knows that the client is performing these exercises correctly when the client is observed doing what?
- A. Alternately dorsiflexing and plantar flexing the feet while the legs are elevated
- B. Massaging the legs beginning at the feet and moving toward the heart
- C. Alternately walking short distances and resting with the legs elevated
- D. Elevating the legs, then dangling them, and then lying flat for three minutes in each position
Correct Answer: D
Rationale: Buerger-Allen exercises involve elevating the legs to promote arterial emptying, dangling to promote filling, and lying flat to rest, performed in cycles to improve circulation.
If the literature supplied by the fast-food chain indicates that one hot apple pie contains 2 g of protein, 14 g of fat, and 31 g of carbohydrates, how many calories are contained in one hot apple pie?
- A. 250 calories
- B. 260 calories
- C. 270 calories
- D. 280 calories
Correct Answer: C
Rationale: Calories are calculated as: (2 g protein × 4 kcal/g) + (14 g fat × 9 kcal/g) + (31 g carbohydrates × 4 kcal/g) = 8 + 126 + 124 = 258 kcal, closest to 270 kcal.
An adult who is admitted for a cardiac catheterization asks the nurse if she will be asleep during the cardiac catheterization. What is the best initial response for the nurse to make?
- A. You will be given a general anesthesia.'
- B. You will be sedated but not asleep.'
- C. The doctor will give you an anesthetic if you are having too much pain.'
- D. Why do you want to be asleep?'
Correct Answer: B
Rationale: During cardiac catheterization, clients receive sedation but remain awake, as their cooperation may be needed. General anesthesia is not used, and pain is managed with sedation, not additional anesthetics. Asking 'why' may make the client defensive and does not provide the requested information.