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The health-care provider has ordered an angiotensin-converting enzyme (ACE) inhibitor for the client diagnosed with congestive heart failure. Which discharge instructions should the nurse include?
- A. Instruct the client to take a cough suppressant if a cough develops.
- B. Teach the client how to prevent orthostatic hypotension.
- C. Encourage the client to eat bananas to increase potassium level.
- D. Explain the importance of taking the medication with food.
Correct Answer: B
Rationale: ACE inhibitors cause hypotension, so teaching prevention of orthostatic hypotension (B) is critical. Cough suppressants (A) are inappropriate for ACE inhibitor cough, bananas (C) are unnecessary unless hypokalemia exists, and food (D) is not required.
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The nurse is teaching a class on valve replacements. Which statement identifies a disadvantage of having a biological tissue valve replacement?
- A. The client must take lifetime anticoagulant therapy.
- B. The client’s infections are easier to treat.
- C. There is a low incidence of thromboembolism.
- D. The valve has to be replaced frequently.
Correct Answer: D
Rationale: Biological valves (D) have limited durability, often requiring replacement. Anticoagulation (A) is for mechanical valves, infections (B) are not easier, and thromboembolism (C) is lower but not a disadvantage.
The client diagnosed with pericarditis is being discharged home. Which intervention should the nurse include in the discharge teaching?
- A. Be sure to allow for uninterrupted rest and sleep.
- B. Refer the client to outpatient occupational therapy.
- C. Maintain oxygen via nasal cannula at two (2) L/min.
- D. Discuss upcoming valve replacement surgery.
Correct Answer: A
Rationale: Rest and sleep (A) reduce cardiac demand in pericarditis. Occupational therapy (B), oxygen (C), and valve surgery (D) are not indicated.
Which statement by the nurse is the best explanation for why the client needs to take the prescribed medication?
- A. It may destroy the virus causing your disease.
- B. It may reduce the scar tissue on the valve.
- C. It may stop blood clots from forming.
- D. It may prevent future bacterial infections.
Correct Answer: D
Rationale: Nafcillin is an antibiotic used to prevent bacterial endocarditis in valvular disease.
Which intervention should the nurse implement with the client diagnosed with dilated cardiomyopathy?
- A. Keep the client in the supine position with the legs elevated.
- B. Discuss a heart transplant, which is the definitive treatment.
- C. Prepare the client for coronary artery bypass graft.
- D. Teach the client to take a calcium channel blocker in the morning.
Correct Answer: B
Rationale: Dilated cardiomyopathy may require heart transplant (B) as definitive treatment in severe cases. Supine position (A) increases preload, CABG (C) is for CAD, and calcium channel blockers (D) are not first-line.
Which data would cause the nurse to question administering digoxin to a client diagnosed with congestive heart failure?
- A. The potassium level is 3.2 mEq/L.
- B. The digoxin level is 1.2 mcg/mL.
- C. The client's apical pulse is 64.
- D. The client denies yellow haze.
Correct Answer: A
Rationale: Hypokalemia (K+ 3.2, A) increases digoxin toxicity risk, warranting caution. Digoxin level 1.2 (B) is therapeutic, pulse 64 (C) is normal, and no yellow haze (D) is expected.