Nokea
A client is admitted with a pulmonary embolism (PE). The client is young, healthy, and active, and has no known risk factors for PE. What action by the nurse is most appropriate?
- A. Encourage the client to walk for 5 minutes each hour.
- B. Refer the client for smoking cessation classes.
- C. Teach the client about factor V Leiden testing.
- D. Explain to the client that sometimes no cause for the disease is found.
Correct Answer: C
Rationale: The correct answer is C because teaching the client about factor V Leiden testing is important in this scenario. Factor V Leiden is a genetic mutation that increases the risk of blood clot formation, including pulmonary embolism. Since the client has no known risk factors for PE, testing for this specific genetic mutation can help identify an underlying cause. Encouraging walking (choice A) is generally beneficial but may not address the root cause. Referring for smoking cessation (choice B) is not relevant in this case. Explaining that sometimes no cause is found (choice D) is not proactive and may lead to missed opportunities for prevention.
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The provider requests the nurse to start an infusion of an inotropic agent on a client. How should the nurse explain the action of these drugs to the client and spouse?
- A. It constricts vessels, improving blood flow.
- B. It dilates vessels, which lessens the work of the heart.
- C. It increases the force of the heart's contractions.
- D. It slows the heart rate down for better filling.
Correct Answer: C
Rationale: The correct answer is C: It increases the force of the heart's contractions. Inotropic agents are medications that enhance the strength of the heart's contractions, improving cardiac output. This explanation is accurate because inotropic agents work by increasing the contractility of the heart muscle, leading to stronger contractions and improved pumping ability.
Explanation for why the other choices are incorrect:
A: It constricts vessels, improving blood flow - This is incorrect because inotropic agents primarily affect the heart's contractility, not vascular constriction.
B: It dilates vessels, which lessens the work of the heart - This is incorrect because inotropic agents do not primarily dilate vessels; their main action is on the heart's contractility.
D: It slows the heart rate down for better filling - This is incorrect because inotropic agents do not slow down the heart rate; they increase the force of contractions.
In summary, choice C is correct as inotropic agents increase the force of
Josie is the mother of a healthy 19-year-old having surgery tomorrow. After the surgeon discusses the surgery, risks, and benefits with the patient and her mother, the mother wants to sign the consent form. The most appropriate response to this would be
- A. Of course she can sign the consent form; after all, the patient is her daughter.
- B. While you appreciate the concern for her daughter, the patient is a consenting adult and legally has to sign her own consent form.
- C. No consent form must be signed.
- D. Why do not both the patient and her mother sign the form?
Correct Answer: B
Rationale: Adult patients have the legal right to consent to their own medical procedures.
A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?
- A. Instruct the client to eliminate all vitamin K from the diet.
- B. Prepare preoperative teaching for an inferior vena cava (IVC) filter.
- C. Refer the client to a chronic illness support group.
- D. Teach the client to use a soft-bristled toothbrush.
Correct Answer: B
Rationale: The correct answer is B: Prepare preoperative teaching for an inferior vena cava (IVC) filter. In the context of a client with an alteration in the gene CYP2C19 and recurrent pulmonary embolism, the use of an IVC filter helps prevent blood clots from traveling to the lungs. This intervention is crucial in managing the risk of further pulmonary embolism. Teaching the client about the purpose, care, and potential complications of the IVC filter is essential for their understanding and cooperation in the treatment plan.
Incorrect Choices:
A: Instruct the client to eliminate all vitamin K from the diet. This choice is not relevant to the management of recurrent pulmonary embolism associated with a genetic alteration.
C: Refer the client to a chronic illness support group. While support is important, it is not the immediate priority in this case of managing a recurrent PE.
D: Teach the client to use a soft-bristled toothbrush. This recommendation is not directly
Because of the rapid elimination of volatile liquids used for general anesthesia, what should the nurse anticipate the patient will need early in the anesthesia recovery period?
- A. Warm blankets
- B. Analgesic medication
- C. Observation for respiratory depression
- D. Airway protection in anticipation of vomiting
Correct Answer: C
Rationale: Rapid elimination can lead to respiratory depression, necessitating close observation.
What is one reason that might apply to a client’s rationale for using alternative therapy?
- A. Desire to become more active in decision-making and self-care.
- B. Chronic incurable back condition.
- C. Difficulty meeting the rising costs of healthcare.
- D. Client does not share traditional American health beliefs and practices.
Correct Answer: A
Rationale: Clients often seek alternative therapies to take a more active role in their healthcare decisions and self-management.