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The nurse is caring for a client with Buerger's disease. The nurse plans on suggesting that the client receives a referral for
- A. occupational therapy.
- B. speech therapy.
- C. smoking cessation.
- D. group psychotherapy.
Correct Answer: C
Rationale: Buerger's disease is strongly linked to smoking, so cessation is critical to prevent disease progression.
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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.
Select the six (6) statements that the nurse should include in the teaching plan for a client with heart failure.
- A. You should weigh yourself every morning before breakfast
- B. Report a gain of more than 2 pounds in one day.
- C. It's important to limit your fluid intake to about 3 liters per day.
- D. Try to include potassium-rich foods like bananas and oranges in your diet every day.
- E. Avoid NSAIDs like ibuprofen unless prescribed by your provider.
- F. Take frequent rest periods throughout the day and gradually increase physical activity as tolerated.
- G. Reduce your sodium intake to less than 2,000 mg per day.
Correct Answer: A,B,D,E,F,G
Rationale: Daily weighing monitors fluid status. Weight gain >2 lbs/day indicates fluid retention. C: Incorrect - Fluid restriction is typically 1.5-2 liters/day in heart failure. D: Correct - Potassium-rich foods support electrolyte balance with diuretics. E: Correct - NSAIDs can worsen heart failure. F: Correct - Rest and gradual activity prevent overexertion. G: Correct - Low sodium reduces fluid retention.
The nurse assists the code team with an unresponsive and pulseless client. Which intervention does the nurse prepare for based on the electrocardiogram (ECG) tracing? See the image below.
- A. Prepare an infusion of sodium bicarbonate
- B. Administer epinephrine
- C. Defibrillation
- D. Cardioversion
Correct Answer: C
Rationale: Defibrillation is the treatment for pulseless ventricular fibrillation or ventricular tachycardia, per ACLS guidelines.
Which of the following findings would the nurse expect to observe in a client who has developed cardiac tamponade? Select all that apply.
- A. Unilateral crackles
- B. Systolic murmur
- C. Bradycardia
- D. Jugular venous distention
- E. Hypotension
Correct Answer: D,E
Rationale: Unilateral crackles suggest pulmonary issues, not tamponade. B: Incorrect - Systolic murmur is not specific to tamponade. C: Incorrect - Tachycardia, not bradycardia, is typical in tamponade due to compensatory mechanisms. D: Correct - Jugular venous distention occurs due to increased venous pressure. E: Correct - Hypotension results from reduced cardiac output in tamponade.
The nurse is visiting a client who was recently prescribed antihypertensive medications. Which statement, if made by the client, requires follow-up?
- A. My pulse decreases after taking my metoprolol.
- B. I started taking my furosemide right before I went to sleep.
- C. I am seasoning my foods with salt substitutes while taking my hydrochlorothiazide.
- D. I wear my clonidine patch for seven days.
Correct Answer: B
Rationale: Taking furosemide, a diuretic, at bedtime can cause nocturia, disrupting sleep and increasing fall risk. It should be taken earlier.
The nurse is caring for a client with the following clinical data. Based on the laboratory tests, which medication would the nurse clarify with the primary healthcare provider (PHCP) prior to administration? See the exhibit for additional client information.
- A. bupropion 150 mg XL PO Daily
- B. clonidine 0.1 mg PO Daily
- C. albuterol 2.5 mg via nebulizer Daily
- D. captopril 12.5 mg PO Daily
Correct Answer: D
Rationale: Captopril, an ACE inhibitor, requires clarification if renal function is impaired (e.g., elevated creatinine), as it can worsen kidney injury.