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Prior to a cardiac catheterization, what instruction should the client be reminded of?
- A. You will need to be NPO for 6 to 8 hours before the procedure.
- B. You will not be able to move around during the procedure.
- C. You will be required to lie still for several hours after the test.
- D. You will not have to drink any fluids immediately before the test.
Correct Answer: A
Rationale: Being NPO (nothing by mouth) for 6 to 8 hours before a cardiac catheterization is crucial to prevent complications such as aspiration during the procedure. This helps ensure the safety and accuracy of the test results by minimizing the risk of food or liquid in the stomach interfering with the procedure. Choice B is incorrect because the client will need to lie still during the procedure to ensure its accuracy. Choice C is incorrect as the client is typically required to lie flat for a few hours after the test, not several hours. Choice D is incorrect as the client is usually not allowed to drink fluids immediately before the test to prevent complications.
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A client with a history of coronary artery disease (CAD) is being discharged after angioplasty. Which instruction should the LPN/LVN reinforce to the client?
- A. You should report any chest pain or discomfort to your health care provider.
- B. Avoid all physical activity for the next 2 weeks.
- C. Return to work immediately after discharge.
- D. Take aspirin only if you experience chest pain.
Correct Answer: A
Rationale: The correct instruction to reinforce is to 'Report any chest pain or discomfort to your health care provider.' This is crucial because chest pain post-angioplasty can indicate complications that need immediate attention. Choice A is incorrect because returning to work immediately may not be advisable after angioplasty, as the client needs time to recover. Choice B is incorrect because avoiding all physical activity for 2 weeks may not be necessary; instead, gradual resumption of activities is usually recommended. Choice D is incorrect because aspirin should be taken as prescribed by the healthcare provider, not just when chest pain occurs.
The LPN/LVN is assisting in the care of a client with chronic heart failure who is receiving digoxin (Lanoxin). Which sign should the nurse monitor for that could indicate digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Hypertension
- D. Hyperglycemia
Correct Answer: A
Rationale: Bradycardia is a common sign of digoxin toxicity and should be closely monitored. Digoxin toxicity can lead to various cardiac dysrhythmias, with bradycardia being a significant indicator. Monitoring the client's heart rate is crucial to detect and manage digoxin toxicity promptly. Tachycardia, hypertension, and hyperglycemia are not typically associated with digoxin toxicity. Tachycardia is more commonly seen with inadequate treatment of heart failure, hypertension is a possible but less common effect, and hyperglycemia is not a typical sign of digoxin toxicity.
A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). Which diagnostic test is most likely to be ordered to confirm this diagnosis?
- A. Echocardiogram
- B. Electrocardiogram (ECG)
- C. Chest X-ray
- D. Complete blood count (CBC)
Correct Answer: B
Rationale: An Electrocardiogram (ECG) is the primary diagnostic tool used to confirm a myocardial infarction. An ECG provides immediate information on cardiac function and can show characteristic changes indicative of a myocardial infarction, such as ST-segment elevation or depression. An echocardiogram (Choice A) is useful for assessing heart structure and function but is not typically used as the primary test for confirming an acute myocardial infarction. Chest X-ray (Choice C) may show certain changes in heart size or pulmonary congestion but is not the primary diagnostic test for MI. A Complete Blood Count (CBC) (Choice D) provides information about the cellular components of blood and is not specific to confirming a myocardial infarction.
A client with chronic stable angina is prescribed nitroglycerin (Nitrostat) for chest pain. The nurse should include which instruction when teaching the client about this medication?
- A. Take nitroglycerin at the first sign of chest pain.
- B. Swallow the tablet whole with water.
- C. Take nitroglycerin with meals to prevent stomach upset.
- D. Store nitroglycerin in a cool, dry place.
Correct Answer: A
Rationale: The correct instruction when teaching a client about nitroglycerin (Nitrostat) is to take it at the first sign of chest pain. Nitroglycerin works rapidly to dilate blood vessels, improving blood flow to the heart muscle. Taking it promptly can help alleviate symptoms quickly and prevent the condition from worsening. Choice B is incorrect because nitroglycerin is usually taken sublingually (under the tongue) and not swallowed. Choice C is incorrect because nitroglycerin is not typically taken with meals. Choice D is incorrect because nitroglycerin should be stored in its original container away from heat and light.
The client is starting therapy with digoxin (Lanoxin). What instruction should the nurse reinforce about the medication?
- A. Take the medication with meals.
- B. Avoid dairy products.
- C. Monitor for yellow or blurred vision.
- D. Increase potassium-rich foods in the diet.
Correct Answer: C
Rationale: The correct answer is C: 'Monitor for yellow or blurred vision.' When a client is taking digoxin, it is crucial to monitor for signs of toxicity, such as yellow or blurred vision, as these can indicate an adverse reaction. Reporting these visual disturbances promptly to the healthcare provider is important for further evaluation and management to prevent potential complications. Choices A, B, and D are incorrect because taking digoxin with meals, avoiding dairy products, or increasing potassium-rich foods are not specific instructions related to monitoring for adverse effects of digoxin therapy.