Nokea
Tachycardia that is a response of the sympathetic nervous system to the pain of ischemia is detrimental because it increases oxygen demand and
- A. increases cardiac output
- B. causes reflex hypotension
- C. may lead to atrial dysrhythmias
- D. impairs perfusion of the coronary arteries
Correct Answer: D
Rationale: Tachycardia reduces diastolic filling time, impairing coronary perfusion.
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If a hypertensive client with asthma takes the maximal dose of his diuretic and his blood pressure still isn't controlled, the nurse understands the next step in controlling his hypertension would be to:
- A. Add enalapril, an ACE inhibitor
- B. Change him to Metoprolol, a beta blocker
- C. Add another diuretic
- D. Increase the drug dosage above recommended dosing levels
Correct Answer: A
Rationale: Step 1: Enalapril is an ACE inhibitor that helps lower blood pressure by blocking the production of angiotensin II, a potent vasoconstrictor.
Step 2: Adding enalapril would be the appropriate next step as it provides an additional mechanism of action to control hypertension.
Step 3: Changing to a beta blocker (B) or adding another diuretic (C) may not address the underlying cause of the uncontrolled hypertension.
Step 4: Increasing the drug dosage above recommended levels (D) can lead to adverse effects without necessarily improving blood pressure control.
To prevent arterial trauma during the use of the IABP, the nurse should
- A. Reposition the patient every 2 hours
- B. Check the site for bleeding every hour
- C. Prevent hip flexion of the cannulated leg
- D. Cover the insertion site with an occlusive dressing
Correct Answer: C
Rationale: Because the IABP is inserted into the femoral artery and advanced to the descending thoracic aorta, compromised distal extremity circulation is common, and requires that the cannulated extremity be extended at all times.
Which of the following is an appropriate nursing intervention for clients with varicose veins?
- A. The nurse assesses the appearance of the ankles and the quality of circulation extending downward.
- B. The nurse assesses the skin, distal circulation, and peripheral edema.
- C. The nurse obtains the family history and identifies the characteristics of the pain.
- D. The nurse assesses the characteristics of chest pain.
Correct Answer: B
Rationale: Assessing skin integrity, distal circulation, and peripheral edema helps monitor complications related to varicose veins.
The client is preparing to have a cardiac stress test. What does the nurse tell the client to do in order to have the test?
- A. The client must lie still throughout the test.
- B. The client will have an EKG after the test.
- C. The client will run on a treadmill.
- D. The test hurts for only a moment.
Correct Answer: C
Rationale: The correct answer is C: The client will run on a treadmill. During a cardiac stress test, the client is required to exercise on a treadmill to increase the heart rate and monitor the heart's response to physical activity. This helps in diagnosing heart conditions such as coronary artery disease. Choice A is incorrect as the client needs to be physically active during the test. Choice B is incorrect as the EKG is typically done before and during the test, not after. Choice D is incorrect as the test involves continuous exercise and monitoring, not a momentary pain.
What are the signs of organ rejection a nurse should closely monitor for when caring for a client after heart transplantation?
- A. Low white blood cell count
- B. ECG changes
- C. Amnesia
- D. Dyspnea
Correct Answer: D
Rationale: Dyspnea, along with fever, fatigue, and decreased exercise tolerance, may indicate organ rejection after heart transplantation.