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The client is at risk for a myocardial infarction due to decreased tissue perfusion as a result of atherosclerosis. Which instructions can the nurse provide the client to reduce the risk?
- A. Teach the client to control the blood pressure to less than 140/90.
- B. Instruct the client to exercise 30 minutes a day three (3) times a week.
- C. Demonstrate how to take the blood pressure using a battery-operated cuff.
- D. Inform the client to limit fat intake and which foods have a higher fat content.
Correct Answer: A,B,D
Rationale: Controlling BP <140/90 (A), exercising 30 min 3×/week (B), and limiting fat (D) reduce MI risk. BP cuff use (C) is monitoring, not prevention.
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The client with coronary artery disease asks why they need a stress test. What is the best response?
- A. It checks for blood clots in your heart.
- B. It evaluates how your heart works under stress.
- C. It measures your cholesterol levels.
- D. It monitors your blood pressure.
Correct Answer: B
Rationale: A stress test assesses heart function during physical stress to detect ischemia or blockages.
The nurse is assessing a client with hypertension. Which finding requires immediate action?
- A. Blood pressure of 160/100 mmHg
- B. Headache rated 4/10
- C. Blurred vision and confusion
- D. Pulse rate of 88 beats per minute
Correct Answer: C
Rationale: Blurred vision and confusion indicate a hypertensive crisis, which can lead to organ damage and requires immediate intervention.
The nurse is administering a beta blocker to the client diagnosed with essential hypertension. Which intervention should the nurse implement?
- A. Notify the health-care provider if the potassium level is 3.8 mEq.
- B. Question administering the medication if the BP is less than 90/60 mm Hg.
- C. Do not administer the medication if the client's radial pulse is greater than 100.
- D. Monitor the client's BP while he or she is lying, standing, and sitting.
Correct Answer: B
Rationale: Beta blockers lower BP; BP <90/60 (B) indicates hypotension, warranting withholding the dose. Potassium 3.8 (A) is normal, pulse >100 (C) is not a contraindication, and orthostatic checks (D) are routine but not primary.
The client diagnosed with a DVT is on a heparin drip at 1,400 units per hour, and Coumadin (warfarin sodium, also an anticoagulant) 5 mg daily. Which intervention should the nurse implement first?
- A. Check the PTT and PT/INR.
- B. Check with the HCP to see which drug should be discontinued.
- C. Administer both medications.
- D. Discontinue the heparin because the client is receiving Coumadin.
Correct Answer: A
Rationale: Check PTT (heparin) and PT/INR (warfarin) (A) to assess therapeutic levels before action. HCP check (B), administering (C), or discontinuing (D) depend on lab results (heparin often continues briefly with warfarin).
The client with peripheral artery disease asks why they need to walk daily. What is the best response?
- A. It strengthens your leg muscles.
- B. It promotes collateral circulation.
- C. It reduces swelling in your legs.
- D. It prevents venous ulcers.
Correct Answer: B
Rationale: Walking stimulates the development of collateral vessels, improving blood flow in peripheral artery disease.