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The nurse is caring for a client diagnosed with coronary artery disease (CAD). Which should the nurse teach the client prior to discharge?
- A. Carry your nitroglycerin tablets in a brown bottle.
- B. Swallow a nitroglycerin tablet at the first sign of angina.
- C. If one nitroglycerin tablet does not work in 10 minutes, take another.
- D. Nitroglycerin tablets have a fruity odor if they are potent.
Correct Answer: A
Rationale: Nitroglycerin should be stored in a dark bottle (A) to maintain potency. Swallowing (B) is incorrect (sublingual), 10 minutes (C) should be 5, and fruity odor (D) is not a potency indicator.
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Which intervention should the nurse implement when administering a loop diuretic to a client diagnosed with coronary artery disease?
- A. Assess the client's radial pulse.
- B. Assess the client's serum potassium level.
- C. Assess the client's glucometer reading.
- D. Assess the client's pulse oximeter reading.
Correct Answer: B
Rationale: Loop diuretics cause hypokalemia, which can precipitate dysrhythmias in CAD. Assessing potassium (B) is critical. Pulse (A), glucose (C), and SpO2 (D) are less directly related.
Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that the client is experiencing a myocardial infarction?
- A. Midepigastric pain and pyrosis.
- B. Diaphoresis and cool, clammy skin.
- C. Intermittent claudication and pallor.
- D. Jugular vein distention and dependent edema.
Correct Answer: B
Rationale: MI causes diaphoresis and cool, clammy skin (B) due to sympathetic activation. Epigastric pain/pyrosis (A) suggest GI issues, claudication/pallor (C) indicate PAD, and JVD/edema (D) suggest heart failure.
Which potential complication should the nurse assess for in the client with infective endocarditis who has embolization of vegetative lesions from the mitral valve?
- A. Pulmonary embolus (PE).
- B. Cerebrovascular accident.
- C. Hemoptysis.
- D. Deep vein thrombosis.
Correct Answer: B
Rationale: Mitral valve vegetations can embolize to the brain, causing a stroke (B). PE (A) is right-sided, hemoptysis (C) is not typical, and DVT (D) is unrelated to embolization.
Which statement by the client diagnosed with coronary artery disease indicates that the client understands the discharge teaching concerning diet?
- A. I will not eat more than six (6) eggs a week.'
- B. I should bake or grill any meats I eat.'
- C. I will drink eight (8) ounces of whole milk a day.'
- D. I should not eat any type of pork products.'
Correct Answer: B
Rationale: Baking or grilling meats (B) reduces fat, aligning with a low-fat CAD diet. Six eggs (A) are excessive, whole milk (C) is high-fat, and avoiding pork (D) is overly restrictive.
The client's telemetry reading shows a P wave before each QRS complex and the rate is 78. Which action should the nurse implement?
- A. Document this as normal sinus rhythm.
- B. Request a 12-lead electrocardiogram.
- C. Prepare to administer the cardiotonic digoxin PO.
- D. Assess the client's cardiac enzymes.
Correct Answer: A
Rationale: P wave before QRS at rate 78 (A) is normal sinus rhythm, requiring documentation. ECG (B), digoxin (C), and enzymes (D) are unnecessary.