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The client with coronary artery disease is prescribed transdermal nitroglycerin, a coronary vasodilator. Which behavior indicates the client understands the discharge teaching concerning this medication?
- A. The client places the medication under the tongue.
- B. The client removes the old patch before placing the new.
- C. The client applies the patch to a hairy area.
- D. The client changes the patch every 36 hours.
Correct Answer: B
Rationale: Removing the old patch (B) ensures proper dosing and prevents overdose. Sublingual (A) is incorrect, hairy areas (C) reduce adhesion, and patches are changed every 24 hours (D).
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Which preprocedure information should be taught to the female client having an exercise stress test in the morning?
- A. Wear open-toed shoes to the stress test.
- B. Inform the client not to wear a bra.
- C. Do not eat anything for four (4) hours.
- D. Take the beta blocker one (1) hour before the test.
Correct Answer: C
Rationale: Fasting for 4 hours (C) prevents nausea and ensures accurate stress test results. Open-toed shoes (A) are unsafe, bras (B) are allowed, and beta blockers (D) may be held to avoid blunting heart rate response.
The client has just received a mechanical valve replacement. Which behavior by the client indicates the client needs more teaching?
- A. The client takes prophylactic antibiotics.
- B. The client uses a soft-bristle toothbrush.
- C. The client takes an enteric-coated aspirin daily.
- D. The client alternates rest with activity.
Correct Answer: C
Rationale: Aspirin (C) is not routinely required post-mechanical valve; warfarin is standard. Antibiotics (A), soft toothbrush (B), and rest/activity (D) are appropriate.
The nurse is caring for a client who suddenly complains of crushing substernal chest pain while ambulating in the hall. Which nursing action should the nurse implement first?
- A. Call a Code Blue.
- B. Assess the telemetry reading.
- C. Take the client's apical pulse.
- D. Have the client sit down.
Correct Answer: D
Rationale: Crushing chest pain suggests ischemia; sitting down (D) reduces oxygen demand. Code Blue (A), telemetry (B), and pulse (C) follow if pain persists.
The nurse and an unlicensed assistive personnel (UAP) are caring for four clients on a telemetry unit. Which nursing task would be best for the nurse to delegate to the UAP?
- A. Assist the client to go down to the smoking area for a cigarette.
- B. Transport the client to the intensive care unit (ICU) via a stretcher.
- C. Provide the client going home discharge-teaching instructions.
- D. Help position the client who is having a portable x-ray done.
Correct Answer: D
Rationale: Positioning for an x-ray (D) is within the UAP’s scope and safe. Smoking (A) is inappropriate, ICU transport (B) requires nursing judgment, and discharge teaching (C) is a nursing responsibility.
The client diagnosed with rule-out myocardial infarction is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first?
- A. Administer sublingual nitroglycerin.
- B. Obtain a STAT electrocardiogram (ECG).
- C. Have the client sit down immediately.
- D. Assess the client's vital signs.
Correct Answer: C
Rationale: Activity-related chest pain suggests ischemia. Having the client sit (C) stops exertion, reducing oxygen demand. Nitroglycerin (A), ECG (B), and vital signs (D) follow.