Nokea
The home health nurse caring for a patient with infective endocarditis overhears the patient making a dental appointment for an extraction next month. Which question is most important for the nurse to ask?
- A. Do you have a toothache?'
- B. Have you contacted your health care provider about your dental appointment?'
- C. Is your dentist board certified?'
- D. Do you think you should wait that long for your tooth extraction?'
Correct Answer: B
Rationale: Patients with endocarditis are put on a protocol of prophylactic antibiotics for any invasive procedure. The dentist and health care provider should be contacted before the extraction.
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A patient is admitted from the emergency department. The emergency department health care provider notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient has which class of heart failure?
- A. moderate heart failure.
- B. severe heart failure.
- C. congestive heart failure.
- D. negligible heart failure.
Correct Answer: B
Rationale: Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest.
The nurse assesses pitting edema that can be depressed approximately $4 \mathrm{~mm}$ and refills in 15 seconds. The nurse would document this assessment as:
- A. +1 edema.
- B. +2 edema.
- C. +3 edema.
- D. +4 edema.
Correct Answer: B
Rationale: A +2 edema can be documented if the skin can be depressed $4 \mathrm{~mm}$ and respond within 15 seconds.
A patient with unstable angina should be provided with instructions to avoid which activity?
- A. Walking outside
- B. Eating red meat
- C. Swimming in warm pool
- D. Shoveling snow
Correct Answer: D
Rationale: The person with angina should be instructed to avoid exposure to cold, heavy exercise, eating heavy meals, and emotional stress.
The pain that a person with arterial insufficiency feels on exertion, which is relieved by rest, is
Correct Answer: intermittent claudication
Rationale: Intermittent claudication is a pain caused by ischemia when a person with arterial insufficiency exerts to the point that the tissues have inadequate oxygen-rich blood. The pain is relieved by rest.
The nurse would reinforce teaching for a patient with Raynaud disease to include which teaching point?
- A. Warming hands and feet with a heating pad
- B. Using mittens in cold weather
- C. Practicing stress-reducing techniques
- D. Complete smoking cessation
- E. Using caution when cleaning the refrigerator or freezer
Correct Answer: B,C,D,E
Rationale: Nursing interventions include patient teaching in techniques for stress reduction, avoiding exposure to cold, and techniques for smoking cessation.