Nokea
The nurse has instructed a client with hyperlipidemia about self-management. Which statement by the client would require follow-up by the nurse?
- A. I should replace hydrogenated vegetable oils with canola oil when cooking.
- B. I should increase my intake of fish like tuna and salmon more often.
- C. Increasing my fiber intake will help lower my cholesterol.
- D. I am glad that I won't need to reduce red meat from my diet.
Correct Answer: D
Rationale: Red meat is high in saturated fat, which worsens hyperlipidemia. The client needs dietary education.
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Which action should the nurse prepare to take for a client experiencing a myocardial infarction? Select all that apply.
- A. Start a peripheral vascular access device (VAD)
- B. Obtain a prescription for albuterol via nebulizer
- C. Obtain a prescription for chewable aspirin
- D. Obtain a prescription for nitroglycerin
- E. Obtain an order for a chest radiograph (x-ray)
- F. Establish continuous cardiac monitoring
Correct Answer: A,C,D,F
Rationale: IV access is needed for medications. B: Incorrect - Albuterol is for respiratory issues, not MI. C: Correct - Aspirin reduces clot formation. D: Correct - Nitroglycerin relieves chest pain and reduces preload. E: Incorrect - Chest X-ray is not a priority in acute MI. F: Correct - Cardiac monitoring detects arrhythmias.
Which of the following statements about sodium are true for a client newly diagnosed with hypertension? Select all that apply.
- A. Sodium cannot be completely eliminated from the diet.
- B. There is no sodium in fresh fruits and vegetables.
- C. Canned vegetables should be avoided.
- D. The body needs some sodium as it plays an important role in water balance.
- E. Reduce daily sodium intake to 2,000 mg
Correct Answer: A,C,D
Rationale: Sodium is naturally present in many foods, making complete elimination impossible. B: Incorrect - Fresh fruits and vegetables contain small amounts of sodium naturally. C: Correct - Canned vegetables are high in sodium and should be avoided or rinsed. D: Correct - Sodium is essential for fluid balance and nerve function. E: Incorrect - Guidelines recommend reducing sodium to 1,500 mg/day for hypertension, not 2,000 mg.
The nurse in the emergency department (ED) is triaging a client with acute chest pain. The nurse should initially
- A. insert a peripheral venous access device (VAD).
- B. obtain a 12-lead electrocardiogram (ECG).
- C. obtain a point-of-care troponin level.
- D. auscultate lung sounds.
Correct Answer: B
Rationale: A 12-lead ECG is the initial step in evaluating acute chest pain to identify myocardial ischemia or infarction.
The following scenario applies to the next 6 items
The client is a 72-year-old male who presents to the emergency department with increasing
shortness of breath over the past two days that gets worse when he is lying flat in bed at night.
Item 1 of 6
History And Physical Nurses' Notes Flow Sheet
0700: The client is a 72-year-old male who presents to the emergency department with increasing shortness of breath over the past two days that gets worse when he is lying flat in bed at night. He states, "I feel like I can't catch my breath," and he had to sleep in a recliner. He reports a 4 lb weight gain over the last week and increasing fatigue. The client is alert and oriented but is using his accessory muscles to breathe. He reports feeling short of breath, orthopnea, and paroxysmal nocturnal dyspnea. He has bilateral pedal edema (+2), bilateral crackles heard upon auscultation, and jugular vein distention noted on his assessment. The
the client has a medical history of hypertension, coronary artery disease, and a prior myocardial infarction. He was diagnosed with heart failure with reduced ejection fraction (HFrEF) two years ago. Current home medications include lisinopril, metoprolol succinate, furosemide, and atorvastatin.
Click to indicate whether each clinical finding is seen in left-sided heart failure, right-sided heart failure, or both.
- A. Crackles auscultated bilaterally
- B. Bilateral lower extremity edema
- C. Paroxysmal nocturnal dyspnea
- D. Fatigue
- E. Weight gain of 4 pounds
- F. Accessory muscle use
- G. Jugular vein distension
Correct Answer: A,B,C,D,E,F,G
Rationale: A: Left-sided - Crackles result from pulmonary edema in left heart failure. B: Right-sided - Edema is due to systemic venous congestion in right heart failure. C: Left-sided - Paroxysmal nocturnal dyspnea is caused by pulmonary congestion. D: Both - Fatigue occurs in both due to reduced cardiac output. E: Right-sided - Weight gain reflects fluid retention from right heart failure. F: Left-sided - Accessory muscle use indicates respiratory distress from pulmonary edema. G: Right-sided - Jugular vein distension is due to right heart failure.
The nurse is caring for a client who appears to be developing heart failure (HF). Which of the following laboratory tests would the nurse expect the primary health care provider (PHCP) to prescribe to confirm the diagnosis?
- A. Basic metabolic panel (BMP)
- B. B-type natriuretic peptide (BNP)
- C. Lipid profile
- D. Troponin
Correct Answer: B
Rationale: BNP is a specific biomarker elevated in heart failure, reflecting ventricular stress and fluid overload.