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The client with a history of coronary artery disease (CAD) is scheduled for a stress test. What instruction should the nurse provide to the client before the test?
- A. Continue taking your usual dose of beta-blockers
- B. Refrain from eating or drinking anything for 4 hours before the test
- C. Wear loose, comfortable clothing and walking shoes
- D. Avoid any physical activity for 24 hours before the test
Correct Answer: C
Rationale: The correct instruction for the client before a stress test is to wear loose, comfortable clothing, and walking shoes. This is crucial as the stress test involves physical exercise, and the client should be prepared for the activity involved. Beta-blockers may need to be adjusted or held before the test as per healthcare provider's instructions. Fasting before the test is not typically required, and avoiding physical activity for 24 hours beforehand is not necessary and may interfere with the accuracy of the test results.
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After a client with a history of myocardial infarction (MI) is prescribed aspirin, which instruction should the nurse include in the discharge teaching?
- A. Take the aspirin with food to prevent gastrointestinal upset
- B. Discontinue the aspirin if you experience ringing in your ears
- C. Take the aspirin at bedtime to minimize side effects
- D. Avoid taking aspirin if you are also taking other NSAIDs
Correct Answer: A
Rationale: The correct instruction is to take aspirin with food to prevent gastrointestinal upset. Aspirin can irritate the stomach lining, leading to potential gastrointestinal issues. Taking it with food helps reduce this risk by providing a protective layer in the stomach. This is a common recommendation to minimize the risk of gastrointestinal side effects when taking aspirin.
A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?
- A. Take one tablet daily with breakfast
- B. Take one tablet every 5 minutes as needed, up to three times
- C. Take one tablet every hour until pain subsides
- D. Take one tablet only if pain does not subside after 30 minutes
Correct Answer: B
Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. If chest pain persists after three doses, the client should seek emergency medical attention as it can indicate a more serious cardiac issue.
A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the LPN/LVN expect to assist with first?
- A. Administer a diuretic as prescribed.
- B. Place the client in a high Fowler's position.
- C. Prepare the client for intubation.
- D. Insert an indwelling urinary catheter.
Correct Answer: B
Rationale: In a client with pulmonary edema, placing them in a high Fowler's position is the priority intervention. This position helps to improve ventilation and oxygenation by decreasing venous return, reducing the workload on the heart, and facilitating fluid redistribution from the lungs. It is crucial to optimize respiratory function and oxygenation before considering other interventions like administering medications, preparing for intubation, or inserting a urinary catheter.
The healthcare professional is caring for a client who has just returned from a cardiac catheterization. The healthcare professional should prioritize which assessment?
- A. Monitoring the client's vital signs every 4 hours
- B. Assessing the puncture site for bleeding
- C. Encouraging the client to ambulate early to prevent complications
- D. Providing the client with fluids to flush out the contrast dye
Correct Answer: B
Rationale: Assessing the puncture site for bleeding is a critical assessment after a cardiac catheterization procedure. This is essential to detect and address any potential complications promptly, such as hemorrhage or hematoma formation. Monitoring the puncture site helps ensure early intervention and prevent further complications, making it the priority assessment in this situation.
A client who had a myocardial infarction (MI) two days ago reports chest pain radiating to the left arm. What should the nurse do immediately?
- A. Administer morphine
- B. Obtain an electrocardiogram (ECG)
- C. Apply oxygen via nasal cannula
- D. Administer sublingual nitroglycerin
Correct Answer: B
Rationale: Obtaining an ECG is crucial in this situation because it helps in assessing for potential complications, such as a recurrent MI or ongoing ischemia. This diagnostic test provides valuable information to guide further interventions and treatment. Administering morphine, oxygen, or nitroglycerin may be necessary but obtaining an ECG takes precedence to evaluate the cardiac status and determine the appropriate course of action.