Nokea
Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer?
- A. Isosorbide mononitrate (Isordil)
- B. Meperidine hydrochloride (Demerol)
- C. Morphine sulfate (Morphine)
- D. Nitroglycerin transdermal patch
Correct Answer: C
Rationale: Morphine sulfate not only decreases pain perception and anxiety but also helps to decrease heart rate, blood pressure, and demand for oxygen. Nitrates are administered for vasodilation and pain control in clients with angina-type pain, but oral forms (such as isosorbide dinitrate) have a large first-pass effect, and transdermal patch is used for long-term management. Meperidine hydrochloride is a synthetic opioid usually reserved for treatment of postoperative or migraine pain.
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The nurse is caring for a client who is status postoperative from a vein stripping. What would the nurse monitor for in the client?
- A. Swelling in the inoperative leg
- B. Blood on the dressing on the inoperative leg
- C. Warm, pink toes in the inoperative leg
- D. Swelling in the operative leg
Correct Answer: D
Rationale: When the client returns from surgery with a gauze dressing covered by elastic roller bandages on the operative leg, the nurse monitors for swelling in the operative leg(s) and its effect on circulation.
The nurse is presenting a workshop at the senior citizens center about how the changes of aging predispose clients to vascular occlusive disorders. What would the nurse name as the most common cause of peripheral arterial problems in the older adult?
- A. Arteriosclerosis
- B. Coronary thrombosis
- C. Atherosclerosis
- D. Raynaud's disease
Correct Answer: C
Rationale: Atherosclerosis is the most common cause of peripheral arterial problems in the older adult. The disease correlates with the aging process. The other choices may occur at any age.
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) immediately following confirmed diagnosis of acute myocardial infarction. The client is overtly anxious and crying. Which response by the nurse is most appropriate?
- A. Everything will be fine. Your family is here for you
- B. Don't cry; you have the best team of doctors
- C. Would you like something to calm your nerves?
- D. Tell me what concerns you most
Correct Answer: D
Rationale: Allowing the client to share feelings tends to relieve or reduce emotional distress. Telling a client that everything is fine negates the feelings they are expressing. Telling a client not to cry can be viewed as insensitive to the feelings being expressed. Providing a prescribed sedative may be helpful but does not address the fears and concerns of the client.
The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD?
- A. Assess the client's mental and emotional status
- B. Assess the skin of the client
- C. Assess the characteristics of chest pain
- D. Assess for any kind of drug abuse
Correct Answer: C
Rationale: The nurse should assess the characteristics of chest pain for a client with CAD. Assessing the client's mental and emotional status, skin, or for drug abuse will not assist the nurse in evaluating the client for CAD. The assessment should be aimed at evaluating for adequate blood flow to the heart.
A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation?
- A. Prothrombin time (PT) or international normalized ratio (INR)
- B. Hourly IV infusion
- C. Vascular sites for bleeding
- D. Urine output
Correct Answer: A
Rationale: The nurse should monitor PT or INR when oral anticoagulation is prescribed. Vascular sites for bleeding, urine output, and hourly IV infusions are generally monitored in all clients.