Nokea
The nurse is caring for a client with the below tracing on the electrocardiogram (ECG). The client reports dyspnea and dizziness. The nurse should obtain a prescription for which medication? See the image below.
- A. Diltiazem
- B. Amiodarone
- C. Labetalol
- D. Atropine
Correct Answer: B
Rationale: Amiodarone is used for ventricular arrhythmias (e.g., ventricular tachycardia), which may cause dyspnea and dizziness.
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The nurse has instructed a client who is scheduled to have a transesophageal echocardiogram (TEE). Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I will need to take antibiotics for one week following this test.
- B. This test will determine if I have any blood clots in my heart.
- C. I will receive general anesthesia for this procedure.
- D. I may feel a flushing sensation when the contrast dye is given.
Correct Answer: B
Rationale: TEE is used to detect intracardiac thrombi, such as in atrial fibrillation, making this statement correct.
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.
The client reporting …………… and …………….would indicate improvement in their condition.
- A. Ambulation tolerance
- B. Edema after activity
- C. Weight loss
- D. Sleeping in bed
- E. High sodium intake
Correct Answer: A,D
Rationale: A: Improved ambulation tolerance indicates better functional capacity. D: Sleeping in bed (without orthopnea) suggests reduced pulmonary congestion. B, C, E: Edema, weight loss, and high sodium intake do not necessarily indicate improvement.
The nurse cares for a client with acute myocardial infarction (AMI). The nurse anticipates the physician will order an emergent
- A. exercise electrocardiography.
- B. computed tomography (CT) of the chest with contrast.
- C. percutaneous coronary intervention (PCI).
- D. echocardiogram.
Correct Answer: C
Rationale: PCI is the standard emergent treatment for AMI to restore coronary blood flow.
The nurse is caring for a client with congestive heart failure experiencing an exacerbation. Which of the following of the client's vital signs would indicate that the client is experiencing a complication?
- A. Decrease in blood pressure
- B. Increase in temperature
- C. Decrease in respiratory rate
- D. Increase in blood pressure
Correct Answer: A
Rationale: A decrease in blood pressure during a CHF exacerbation may indicate cardiogenic shock, a serious complication.
The following scenario applies to the next 1 items
The nurse in the intensive care unit (ICU) is caring for 58-year-old male client
Item 1 of 1
Medical History Vital Signs Medication Administration Record
• atrial fibrillation
• chronic obstructive pulmonary disease
• hyperlipidemia
• chronic back pain
Based on the 2000 vital signs, select two (2) immediate actions the nurse should take for a client with atrial fibrillation, COPD, hyperlipidemia, and chronic back pain.
- A. Stop the diltiazem infusion
- B. Apply supplemental oxygen via nonrebreather face mask
- C. Stop the 0.9% saline infusion
- D. Notify the primary healthcare provider
- E. Assess the client for back pain
- F. Request a prescription to change the intravenous fluids to hypertonic saline
Correct Answer: B,D
Rationale: Supplemental oxygen addresses potential hypoxia from COPD or atrial fibrillation complications. D: Correct - Notifying the provider ensures timely management of abnormal vital signs. A, C, E, F: Incorrect - No vital sign data suggests stopping infusions, assessing back pain, or changing to hypertonic saline.