Nokea
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.
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You are the charge nurse for the coronary care step-down unit. Which patient is best to assign to an RN who has floated for the day from the general medical-surgical unit?
- A. Patient requiring discharge teaching about coronary artery stenting prior to going home with spouse today.
- B. Patient receiving IV furosemide (Lasix) to treat acute left ventricular failure.
- C. Patient just transferred from the radiology department after a coronary angioplasty.
- D. Patient just admitted with unstable angina and who has orders for a heparin infusion and aspirin
Correct Answer: A
Rationale: Discharge teaching is less complex and allows the floating RN to focus on educating without needing extensive cardiac experience.
What is a condition where the heart's electrical impulses are blocked or delayed, leading to a slower or irregular heartbeat?
- A. Heart block
- B. Atrial fibrillation
- C. Tachycardia
- D. Bradycardia
Correct Answer: A
Rationale: The correct answer is A: Heart block. Heart block refers to a condition where the heart's electrical impulses are blocked or delayed, leading to a slower or irregular heartbeat. This occurs when there is interference with the electrical signals that control the heart's rhythm as they travel through the heart's conduction system. Atrial fibrillation (B) is an irregular and often rapid heart rate that can occur due to chaotic electrical signals in the heart's upper chambers. Tachycardia (C) is a condition where the heart rate is too fast, not slower or irregular. Bradycardia (D) refers to a slow heart rate but not necessarily due to electrical impulse blockage.
At what point in the healing process of the myocardium following an infarct does early scar tissue result in an unstable heart wall?
- A. 2 to 3 days after MI
- B. 4 to 10 days after MI
- C. 10 to 14 days after MI
- D. 6 weeks after MI
Correct Answer: B
Rationale: Scar tissue forms 4 to 10 days post-MI.
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.
What is the primary effect of a calcium channel blocker on the heart?
- A. Decreases heart rate
- B. Increases heart rate
- C. Increases blood pressure
- D. Decreases blood pressure
Correct Answer: D
Rationale: The primary effect of a calcium channel blocker on the heart is to decrease blood pressure. Calcium channel blockers block the entry of calcium into the smooth muscle cells of blood vessels and the heart. This causes vasodilation and reduces the force of contraction in the heart, leading to a decrease in blood pressure. Choices A and B are incorrect as calcium channel blockers typically do not directly affect heart rate. Choice C is incorrect because calcium channel blockers actually tend to lower blood pressure rather than increase it.