Nokea
The nurse cares for a client with acute myocardial infarction (AMI). The nurse anticipates the physician will order an emergent
- A. exercise electrocardiography.
- B. computed tomography (CT) of the chest with contrast.
- C. percutaneous coronary intervention (PCI).
- D. echocardiogram.
Correct Answer: C
Rationale: PCI is the standard emergent treatment for AMI to restore coronary blood flow.
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Which interventions would be appropriate for a client with decreased cardiac output? Select all that apply.
- A. Apply compression stockings
- B. Obtain a prescription for nitroglycerin via transdermal patch
- C. Elevate the client's legs
- D. Implement fall precautions
- E. Educate the client about not straining when defecating
Correct Answer: A,D,E
Rationale: Compression stockings improve venous return, supporting cardiac output. B: Incorrect - Nitroglycerin reduces preload, potentially worsening cardiac output in some cases. C: Incorrect - Leg elevation is not standard for low cardiac output and may worsen symptoms. D: Correct - Fall precautions are needed due to potential weakness or syncope. E: Correct - Avoiding straining prevents Valsalva maneuver, which can reduce cardiac output.
The nurse has instructed a client who is scheduled to have a transesophageal echocardiogram (TEE). Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I will need to take antibiotics for one week following this test.
- B. This test will determine if I have any blood clots in my heart.
- C. I will receive general anesthesia for this procedure.
- D. I may feel a flushing sensation when the contrast dye is given.
Correct Answer: B
Rationale: TEE is used to detect intracardiac thrombi, such as in atrial fibrillation, making this statement correct.
Which of the following lifestyle modifications are recommended for managing essential hypertension? Select all that apply.
- A. Isometric exercises
- B. Decreasing sodium intake
- C. Smoking cessation
- D. Use of herbal supplements
- E. Weight loss
Correct Answer: B,C,E
Rationale: Isometric exercises can increase blood pressure and are not recommended. Reducing sodium intake helps lower blood pressure. C: Correct - Smoking cessation reduces cardiovascular risk. D: Incorrect - Herbal supplements are not universally recommended and may interact with medications. E: Correct - Weight loss reduces blood pressure and cardiovascular strain.
The nurse is caring for a client who was admitted for an exacerbation of congestive heart failure.
• Click to highlight the findings in the nurses' note which indicate that the client is progressing towards discharge.
Nurses Notes
Day 1 - 0900 - The client was ambulated 25 feet and did not tolerate the ambulation reporting dyspnea. Gait was unsteady. Provided education on aerobic exercise and the benefits for heart failure.
Client verbally taught back the education with understanding.
Day 3 - 0915 - The client ambulated 30 feet in the hallway without assistance. Gait was steady. The oxygen saturation after ambulation was 95% on room air. Scheduled furosemide was refused by the client.
Educated the client on the purpose of the medication and its benefits.
Click to highlight the findings in the nurses' note which indicate that the client is progressing towards discharge.
- A. The client was ambulated 25 feet and did not tolerate the ambulation reporting dyspnea.
- B. Gait was unsteady.
- C. Provided education on aerobic exercise and the benefits for heart failure.
- D. The client ambulated 30 feet in the hallway without assistance. Gait was steady.
- E. The oxygen saturation after ambulation was 95% on room air.
- F. Scheduled furosemide was refused by the client.
Correct Answer: C,D,E
Rationale: C: Correct - Education with client understanding indicates progress in self-management. D: Correct - Ambulating 30 feet without assistance and with steady gait shows improved physical tolerance. E: Correct - Oxygen saturation of 95% on room air post-ambulation indicates stable respiratory status. A, B, F: Incorrect - Dyspnea, unsteady gait, and medication refusal suggest ongoing issues, not progress toward discharge.
The nurse is caring for a client with the below tracing on the electrocardiogram. The nurse should expect the client to demonstrate which clinical manifestation in conjunction with this electrocardiogram tracing? See the exhibit.
- A. Jugular venous distention (JVD)
- B. Systolic murmur
- C. Irregular pulse
- D. Widened pulse pressure
Correct Answer: C
Rationale: An irregular ECG tracing, such as in atrial fibrillation, typically correlates with an irregular pulse due to inconsistent ventricular contractions.