Nokea
The nurse assesses the client at a vascular clinic after being treated with pentoxifylline for 6 weeks. The nurse determines that pentoxifylline has been effective when noting that the client has which finding?
- A. A decrease in lower-extremity edema
- B. No symptoms of withdrawal after quitting smoking
- C. A venous ulcer on the ankle that has decreased in size
- D. The ability to walk a longer distance without claudication
Correct Answer: D
Rationale: Pentoxifylline (Trental) is thought to act by improving capillary blood flow and is prescribed to decrease intermittent claudication. Effects are usually seen in 2 to 4 weeks. Edema, smoking withdrawal, and venous ulcers are not treated by pentoxifylline.
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At 0745 hours, the nurse is informed by the HCP that a cardiac catheterization is to be completed on the client at 1400 hours. Which intervention should be the nurse’s priority?
- A. Place the client on NPO (nothing per mouth) status.
- B. Teach the client about the cardiac catheterization.
- C. Start an intravenous (IV) infusion of 0.9% NaCl.
- D. Witness the client’s signature on the consent form.
Correct Answer: A
Rationale: A cardiac catheterization is an invasive procedure requiring the client to lie still in a supine position. The client is usually sedated with medication, such as midazolam, during the procedure. To avoid aspiration, the client should be NPO 6 to 12 hours prior to the procedure, making this the priority at 0745 for a 1400 procedure.
The nurse is teaching the client newly diagnosed with chronic stable angina. Which instructions on measures to prevent future angina should the nurse incorporate? Select all that apply.
- A. Increase isometric arm exercises to build endurance.
- B. Wear a facemask when outdoors in cold weather.
- C. Take nitroglycerin before a stressful event even if pain free.
- D. Perform most exertional activities in the morning.
- E. Take a daily laxative to avoid straining with bowel movements.
- F. Discontinue use of all tobacco products if you use these.
Correct Answer: B;C;F
Rationale: The nurse should instruct: B) Wearing a facemask in cold weather to prevent vasoconstriction; C) Taking nitroglycerin prophylactically to improve coronary blood flow; F) Discontinuing tobacco to reduce vasoconstriction. Isometric exercises, morning exertion, and daily laxatives are not recommended as they may increase cardiac workload or cause other issues.
The client, returning from a coronary catheterization in which the femoral artery approach was used, sneezes. Which should be the nurse’s priority intervention?
- A. Palpate pedal pulses
- B. Measure vital signs
- C. Assess for urticaria
- D. Check the insertion site
Correct Answer: D
Rationale: Checking the insertion site is priority. Sneezing increases intra-abdominal pressure and increases the risk for clot disruption and bleeding from the femoral artery. Pedal pulses, vital signs, and urticaria are secondary concerns.
The client is discovered to have a popliteal aneurysm. Because of the aneurysm, the nurse should closely monitor the client for which associated problem?
- A. Thoracic outlet syndrome
- B. Ischemia in the lower limb
- C. Pulmonary embolism
- D. Raynaud’s phenomenon
Correct Answer: B
Rationale: A popliteal aneurysm (located in the space behind the knee) may cause ischemia in the leg distal to the aneurysm due to thrombus forming inside the aneurysm and potential emboli. Other options are unrelated to popliteal aneurysms.
After receiving normal CXR results of the client who had cardiac surgery, the nurse proceeds to remove the client’s chest tubes as prescribed. Which intervention should be the nurse’s priority?
- A. Auscultate the client’s lung sounds
- B. Administer 2 mg morphine sulfate intravenously
- C. Turn off the suction to the chest drainage system
- D. Prepare the dressing supplies at the client’s bedside
Correct Answer: B
Rationale: Because the peak action of morphine sulfate is 10 to 15 minutes, this should be administered first to manage pain during chest tube removal. Auscultation, turning off suction, and preparing supplies are secondary.