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The nurse is discharging a client with heart failure who is prescribed digoxin and furosemide. Which of the following laboratory tests must the client have monitored due to this combination of prescribed medications?
- A. Fecal occult blood
- B. Serum electrolytes
- C. Urinalysis
- D. Glycosylated hemoglobin
Correct Answer: B
Rationale: Furosemide can cause hypokalemia, increasing digoxin toxicity risk, so serum electrolytes (especially potassium) must be monitored.
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A client is being discharged following the insertion of a permanent pacemaker. Which of the following should be included in the client's discharge instructions?
- A. Air travel will not be possible due to airport screening equipment.
- B. You will need to discard any radios at home that have antennas.
- C. Computed tomography (CT) scans are not permitted with this device.
- D. You should use your cellular phone on the opposite side of the generator.
Correct Answer: D
Rationale: Using a cell phone on the opposite side of the pacemaker reduces electromagnetic interference.
The nurse is planning care for a client admitted with infective endocarditis (IE). Which assessment finding would indicate that the client is experiencing a complication?
- A. petechial rashes
- B. flank pain
- C. headache
- D. fever
Correct Answer: B
Rationale: Flank pain may indicate renal embolism, a complication of infective endocarditis due to septic emboli.
The following scenario applies to the next 1 items
The nurse in the emergency department is triaging a client.
Item 1 of 1
Nurses' Notes
Orders
Diagnostic Results
0819: The client reports feeling "tightness in the chest" for the last 30 minutes. The pain came on suddenly while he was in bed. He describes the pain as a pressure-like sensation radiating to his left arm. He states that the pain is 'severe.' The pain does not improve with rest or changing positions. The client reported one year ago, he had this chest pain that was relieved with nitroglycerin. Upon assessment, the client was anxious and had a flushed appearance. Clear lung sounds bilaterally. Peripheral pulses 2+. Physician was called to the triage room where verbal orders were received. Medical history of diabetes mellitus (type two), hypertension, and hyperlipidemia.
For each assessment finding below, click to specify if the finding is consistent with the condition of stable angina or unstable angina.
- A. Location of pain
- B. Onset of pain
- C. ECG findings
- D. Pain intensity
- E. Duration of pain
- F. Medical history
Correct Answer: B,C,D,E
Rationale: A: Both - Pain location (chest, radiating to arm) is similar in both stable and unstable angina. B: Unstable angina - Sudden onset while at rest is characteristic of unstable angina. C: Unstable angina - ECG changes (e.g., ST depression) are more likely in unstable angina. D: Unstable angina - Severe pain is typical of unstable angina. E: Unstable angina - Prolonged pain duration is associated with unstable angina. F: Both - Medical history (e.g., hypertension, diabetes) is relevant to both conditions.
The nurse has instructed a client with hyperlipidemia about self-management. Which statement by the client would require follow-up by the nurse?
- A. I should replace hydrogenated vegetable oils with canola oil when cooking.
- B. I should increase my intake of fish like tuna and salmon more often.
- C. Increasing my fiber intake will help lower my cholesterol.
- D. I am glad that I won't need to reduce red meat from my diet.
Correct Answer: D
Rationale: Red meat is high in saturated fat, which worsens hyperlipidemia. The client needs dietary education.
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.