Nokea
The nurse caring for a patient recovering from a myocardial infarction (MI) administers stool softeners for which reason?
- A. Prevent enema dependence in the hospitalized patient
- B. Prevent fecal impactions which can lead to bowel obstruction
- C. Stool softeners reduce the need for laxatives once the patient is discharged
- D. Reduce the necessity to strain at the stool to lessen the effect of Valsalva's maneuver
Correct Answer: D
Rationale: Stool softeners will lessen the severity of straining and will decrease the effect of the Valsalva's maneuver on intrathoracic pressure.
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During a health interview by the home health nurse, which patient report suggests left-sided heart failure?
- A. I have to sleep in my recliner and I have this hacking cough.'
- B. I have no appetite and I have lost $3 \mathrm{lb}$ in the last week.'
- C. I have to urinate every 2 hours, even during the night.'
- D. I go barefoot most of the time because my feet are so hot.'
Correct Answer: A
Rationale: Left ventricular failure is often among the first of signs and symptoms of decreased cardiac output. The second is pulmonary congestion. Signs and symptoms of this condition include dyspnea, orthopnea, pulmonary crackles, hemoptysis, and cough.
Which statement would lead the nurse to offer more instruction about taking warfarin?
- A. I eat a banana every morning with breakfast.'
- B. I try to eat more green leafy vegetables, especially broccoli, spinach, and kale.'
- C. I try to eat a well-balanced, low-fat diet.'
- D. I don't drink alcohol or caffeine.'
Correct Answer: B
Rationale: Avoid marked changes in eating habits, such as dramatically increasing foods high in vitamin K (e.g., broccoli, spinach, kale, greens). Limit alcohol intake to small amounts.
The nurse is aware that which layer is the muscle layer of the heart, which is responsible for the heart's contraction?
- A. endocardium.
- B. pericardium.
- C. mediastinum.
- D. myocardium.
Correct Answer: D
Rationale: The myocardium is the specialized muscle layer that allows the heart to contract.
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 nurse reminds the patient who is taking warfarin for the treatment of peripheral artery disease not to eat excessive green and yellow vegetables for which reason?
- A. Potassium in the vegetables can cause additional bleeding
- B. Green and yellow vegetables cause loose bowel movements
- C. Vitamin $\mathrm{K}$ in the vegetables counteracts the anticoagulant effect
- D. Potassium in the vegetables can cause hyperkalemia to develop
Correct Answer: C
Rationale: The patient taking warfarin should not eat excessive amounts of vitamin $\mathrm{K}$ containing foods, such as green and yellow vegetables. Vitamin $\mathrm{K}$ counteracts the anticoagulant effect, and blood clots could develop.