Nokea
The nurse is caring for a client with ECG changes consistent with a myocardial infarction. Which of the following diagnostic test does the nurse anticipate to confirm heart damage?
- A. Fluoroscopy
- B. Nuclear cardiology
- C. Serum blood work
- D. Chest radiography
Correct Answer: B
Rationale: Nuclear cardiology uses a radionuclide to detect areas of myocardial damage. Chest radiography and fluoroscopy determine the size and position of the heart and condition of the lungs. Serum blood work notes elevations in enzymes suggesting tissue damage.
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The nurse provides care for a post-cardiac catheterization male client in the postprocedure room. Which is a priority nursing action for this client?
- A. Evaluate the client's temperature.
- B. Encourage the client to drink fluids.
- C. Advise the client to void while lying flat with a urinal.
- D. Monitor the client's pressure dressing.
Correct Answer: D
Rationale: Following cardiac catheterization, the client has a pressure dressing placed over the catheter site to control bleeding. After the procedure, the nurse checks the dressing over the insertion site frequently for signs of bleeding. Additionally, the nurse monitors the client's blood pressure (BP) and pulse frequently to detect complications; however, it is not a priority for the nurse to monitor the client's temperature after this procedure. Although the client is encouraged to drink fluids as part of the discharge instructions to assist with flushing the dye used during the procedure, this is not a priority nursing action for this client in the postprocedure period of care. The client is taught to void while lying flat using a urinal; however, this is not the priority action based on the current data.
The nurse is assessing a client who has dyspnea and considering the process of gas exchange. Which structural characteristic of capillaries best enables gas exchange at the cellular level?
- A. Capillaries are one cell-layer thick.
- B. Capillaries form a complex network
- C. Capillaries transport blood back to the heart.
- D. Capillaries are elastic structures.
Correct Answer: A
Rationale: Capillaries are one cell-layer thick and in direct contact with the cells of all tissues. This allows ease of gas exchange. Capillaries do form a complex network; however, it is the one cell structure that facilitates gas exchange. Venules and veins transport blood back to the heart. Arteries are elastic.
Which suggestion can the nurse provide to an older adult client to reduce the symptoms associated with sarcopenia?
- A. Maintain hydration.
- B. Avoid heavy lifting.
- C. Practice brisk walking.
- D. Limit the use of caffeine.
Correct Answer: C
Rationale: Sarcopenia refers to changes in composition of muscle tissue that can occur in aging because of deconditioning; therefore, increasing daily exercise helps to improve muscle strength, including the heart. Maintaining hydration is important for a client who requires cardiac catheterization to flush the dye used during the procedure from the system and is not an intervention supported by evidence-based practice guidelines for the client who experiences sarcopenia. Heavy lifting is discouraged following cardiac catheterization; however, avoiding lifting is not an activity that reduces symptoms associated with sarcopenia. The nurse discourages the use of caffeine for clients who experience tachycardia; however, this is not an appropriate suggestion to reduce the symptoms associated with sarcopenia.
The following clients are in need of exercise electrocardiography. Which client would the nurse indicate as most appropriate for a drug-induced stress test?
- A. A 48-year-old policemen with history of knee replacement 4 years ago
- B. A 68-year-old housewife with history of osteoporosis
- C. A 72-year-old retired janitor obtaining a cardiac baseline
- D. A 55-year-old recovering from a fall and broken femur
Correct Answer: D
Rationale: An exercise electrocardiography or stress test monitors the electrical activity of the heart while the client walks on a treadmill. If a client has a sedentary lifestyle or physical disability, cardiac medications may be administered to stress the heart similar to activity. Even though the client is middle aged at 55 years old, the client is recovering from a broken femur thus would be unable to have vigorous exercise. None of the other clients have a history which precludes them from exercise electrocardiography.
The nurse is reviewing lab work for a client whose blood CO2 level is elevated. The nurse is most correct to suspect an impairment of which?
- A. Alveoli
- B. Bronchi
- C. The pulmonary artery
- D. The pulmonary vein
Correct Answer: A
Rationale: Gas exchange occurs in the lung where oxygen in inspired air exchanges for CO2 in the venous blood. The CO2 is then transferred to the alveoli to be exhaled. No gas exchange occurs in the bronchi. The pulmonary artery carries deoxygenated blood to the lungs, and the pulmonary vein brings oxygenated blood back to the heart to be pumped to the tissues.