The client diagnosed with a myocardial infarction (MI) is be...

The client diagnosed with a myocardial infarction (MI) is being discharged. Which discharge instruction(s) should the nurse teach the client?

A. Call the health care provider (HCP) if any chest pain happens.
B. Discuss when the client can resume sexual activity.
C. Explain the pharmacology of nitroglycerin tablets.
D. Encourage the client to sleep with the head of the bed elevated.

Correct Answer: A,B,C

Rationale: Instructing to call HCP for chest pain (A), discussing sexual activity (B), and explaining nitroglycerin (C) ensure safety and recovery. HOB elevation (D) is for CHF, not MI.

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The client comes to the emergency department saying, 'I am having a heart attack.' Which question is most pertinent when assessing the client?

A. Can you describe your chest pain?'
B. What were you doing when the pain started?'
C. Did you have a high-fat meal today?'
D. Does the pain get worse when you lie down?'

Correct Answer: A

Rationale: Describing chest pain (A) is most pertinent to differentiate cardiac from non-cardiac causes. Activity (B), diet (C), and positional pain (D) are secondary.

According to the 2010 American Heart Association Guidelines, which steps of cardiopulmonary resuscitation for an adult suffering from a cardiac arrest should the nurse teach individuals in the community? Rank in order of performance.

A. Place the hands over the lower half of the sternum.
B. Look for obvious signs of breathing.
C. Begin compressions at a ratio of 30:2.
D. Call for an AED immediately.
E. Position the victim on the back.

Correct Answer: E,B,D,A,C

Rationale: 1. Position on back (E): Ensures a firm surface. 2. Look for breathing (B): Confirms arrest. 3. Call for AED (D): Activates help. 4. Place hands on sternum (A): Prepares for compressions. 5. Begin compressions 30:2 (C): Starts CPR.

Which intervention should the nurse implement when defibrillating a client who is in ventricular fibrillation?

A. Defibrillate the client at 50, 100, and 200 joules.
B. Do not remove the oxygen source during defibrillation.
C. Place petroleum jelly on the defibrillator pads.
D. Shout 'all clear' prior to defibrillating the client.

Correct Answer: D

Rationale: Shouting 'all clear' (D) ensures safety before defibrillation. Energy levels (A) are 200–360 joules, oxygen (B) is removed to prevent fire, and petroleum jelly (C) is not used.

The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?

A. The client with three (3) unifocal PVCs in one (1) minute.
B. The client diagnosed with coronary artery disease who wants to ambulate.
C. The client diagnosed with mitral valve prolapse with an audible S3.
D. The client diagnosed with pericarditis who is in normal sinus rhythm.

Correct Answer: C

Rationale: An S3 in mitral valve prolapse (C) suggests heart failure, requiring immediate assessment. Unifocal PVCs (A) are less urgent, ambulation (B) is routine, and normal rhythm in pericarditis (D) is stable.

The client diagnosed with congestive heart failure is complaining of leg cramps at night. Which nursing interventions should be implemented?

A. Check the client for peripheral edema and make sure the client takes a diuretic early in the day.
B. Monitor the client's potassium level and assess the client's intake of bananas and orange juice.
C. Determine if the client has gained weight and instruct the client to keep the legs elevated.
D. Instruct the client to ambulate frequently and perform calf-muscle stretching exercises daily.

Correct Answer: B

Rationale: Leg cramps in CHF may indicate hypokalemia from diuretics. Monitoring potassium and assessing potassium-rich food intake (B) is appropriate. Edema/diuretic timing (A), weight/elevation (C), and ambulation/stretching (D) are less directly related.