Nokea
The nurse is caring for a client with the below tracing on the electrocardiogram (ECG). The nurse should anticipate which prescription from the primary healthcare provider (PHCP)?
- A. captopril
- B. atropine
- C. adenosine
- D. diltiazem
Correct Answer: B
Rationale: Atropine is used to treat bradycardia, which may be indicated by certain ECG tracings showing slow heart rates. Captopril is an ACE inhibitor for hypertension or heart failure, adenosine is used for supraventricular tachycardia, and diltiazem is a calcium channel blocker for rate control in atrial arrhythmias.
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An emergency department nurse is caring for a client who presented with fatigue, muscular weakness, and dyspnea. Upon assessment, the client was noted to be coughing frequently and sitting in a tripod position. A subsequent diagnosis of left ventricular failure was made. The nurse understands that manifestations of left-sided heart failure present as respiratory issues because:
- A. There is venous congestion in the liver.
- B. There is hypoperfusion of tissue cells.
- C. There is pulmonary congestion.
- D. Despite normal cardiac output, the heart cannot meet the accelerated demands of the body.
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, leading to respiratory symptoms like dyspnea and cough.
The nurse is teaching a client who is scheduled for an exercise electrocardiography (ECG) test. Which of the following statements by the client would require follow-up?
- A. I should wear loose, comfortable clothing with non-slip athletic footwear.
- B. I may have a small cup of coffee before the exam.
- C. I will have my blood pressure, heart rate, and rhythm obtained before, during, and after the stress test.
- D. I should not do any strenuous activity before the test.
Correct Answer: B
Rationale: Caffeine can affect heart rate and ECG results, so coffee should be avoided before an exercise ECG test.
The nurse has instructed a client who is scheduled to have a carotid ultrasound. Which of the following statements by the client would require follow up?
- A. I plan to eat a light meal before the ultrasound.
- B. I will remove any jewelry or metal objects from my neck before the procedure.
- C. I understand that the ultrasound will use sound waves to create images of my carotid arteries.
- D. I should fast for at least 8 hours before the ultrasound.
Correct Answer: D
Rationale: Carotid ultrasound does not require fasting, so this statement requires correction.
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.
History of Present Illness (HPI)
The client was found disoriented upon arrival and in acute respiratory distress.
The client's caregiver noted that the prescribed medications had not been
taken for several days. Medical history includes hypertension, diabetes mellitus,
congestive heart failure, and arthritis. Client Assessment Bounding peripheral pulses,
normotensive, crackles in the lung fields, tachypnea, jugular venous distention, and
abdominal distention.
Diagnosis
1. Pulmonary edema
2. Acute decompensated heart failure
Based on the clinical data, which prescription would the nurse request from the primary healthcare provider for a client with pulmonary edema and acute decompensated heart failure? Select all that apply.
- A. Albuterol
- B. Hydrocortisone
- C. Diltiazem
- D. Nitroglycerin
- E. Furosemide
Correct Answer: D,E
Rationale: Albuterol is for bronchospasm, not pulmonary edema. B: Incorrect - Hydrocortisone is not indicated for heart failure. C: Incorrect - Diltiazem is for rate control, not fluid overload. D: Correct - Nitroglycerin reduces preload, alleviating pulmonary edema. E: Correct - Furosemide is a diuretic to reduce fluid overload.