Nokea
If the client's pain is due to a myocardial infarction (MI), which prescribed medication would be most helpful?
- A. A nonsteroidal anti-inflammatory drug such as ibuprofen (Advil)
- B. A nonsalicylate such as acetaminophen (Tylenol)
- C. A salicylate such as aspirin
- D. An opioid such as morphine sulfate
Correct Answer: C
Rationale: Aspirin is critical in MI to inhibit platelet aggregation and prevent further thrombus formation.
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The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this client?
- A. Apical pulse rate of 110 and 4+ pitting edema of feet.
- B. Thick white sputum and crackles that clear with cough.
- C. The client sleeping with no pillow and eupnea.
- D. Radial pulse rate of 90 and CRT less than three (3) seconds.
Correct Answer: A
Rationale: CHF exacerbation causes fluid overload, leading to tachycardia (apical pulse 110) and severe edema (4+ pitting, A). Thick sputum/crackles (B) suggest pneumonia, sleeping flat with eupnea (C) is unlikely, and normal CRT (D) doesn’t reflect CHF severity.
A male client with angina pectoris has been having an increased number of episodes of pain recently. He is admitted for observation. During the admission interview, he tells the nurse that he has been having chest pain during the last week. Which statement by the client would be of greatest concern to the nurse?
- A. I had chest pain while I was walking in the snow on Thursday.'
- B. We went out for a big dinner to celebrate my wife's birthday, but I couldn't enjoy it because I got the pain before we got home from the restaurant.'
- C. I had chest pain yesterday while I was sitting in the living room watching television.'
- D. I felt pain all the way down my left arm after I was playing with my grandson on Monday.'
Correct Answer: C
Rationale: Chest pain at rest, such as while watching television, is concerning as it may indicate unstable angina or impending myocardial infarction, requiring urgent evaluation. Pain with activity, eating, or radiating to the arm is typical of angina but less immediately alarming.
When two rescuers perform CPR on an adult, what is the ratio of compressions to ventilations?
- A. 30 compressions to 2 breaths
- B. 10 compressions to 1 breath
- C. 1 compression for each breath
- D. 1 compression to 5 breaths
Correct Answer: A
Rationale: Two-rescuer adult CPR uses a 30:2 ratio to balance circulation and oxygenation.
A client is being seen in the clinic to rule out (R/O) mitral valve stenosis. Which assessment data would be most significant?
- A. The client complains of shortness of breath when walking.
- B. The client has jugular vein distention and 3+ pedal edema.
- C. The client complains of chest pain after eating a large meal.
- D. The client's liver is enlarged and the abdomen is edematous.
Correct Answer: A
Rationale: Shortness of breath on exertion (A) is a hallmark of mitral valve stenosis due to impaired left atrial emptying. JVD/edema (B), postprandial pain (C), and liver/abdominal edema (D) suggest right-sided failure or other causes.
The client who is one (1) day postoperative coronary artery bypass surgery is exhibiting sinus tachycardia. Which intervention should the nurse implement?
- A. Assess the apical heart rate for one (1) full minute.
- B. Notify the client's cardiac surgeon.
- C. Prepare the client for synchronized cardioversion.
- D. Determine if the client is having pain.
Correct Answer: D
Rationale: Sinus tachycardia post-CABG is often due to pain (D), which should be assessed first. Heart rate (A), notifying (B), and cardioversion (C) follow if needed.