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The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. The nurse should do which intervention to effectively accomplish this goal?
- A. Provide a quiet and low-stimulus environment.
- B. Encourage the family to come visit very frequently.
- C. Encourage the client to call friends and relatives each day.
- D. Recommend that the client watch TV as a constant diversion.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client diagnosed with angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?
- A. I am considering cutting my workload.
- B. I need to cut down on cigarette smoking.
- C. I am so relieved that my heart is repaired.
- D. I need to adhere to my dietary restrictions.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
While preparing a client for a cardiac catheterization, the client expresses a preference to speak with their doctor rather than the nurse. Which response by the nurse should be therapeutic?
- A. Your doctor expects me to prepare you for this procedure.
- B. That's fine, if that's what you want. I'll call your health care provider.
- C. So you're saying that you want to talk to your health care provider?
- D. I'm concerned with the way you've dismissed me. I know what I am doing.
Correct Answer: C
Rationale: The therapeutic response by the nurse in this situation involves reflecting the client's feelings back to them, which demonstrates active listening and empathy. By restating the client's preference to talk to their doctor, the nurse acknowledges and validates the client's feelings, thereby fostering a positive therapeutic relationship and promoting open communication.
The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which intervention should the nurse implement when providing care for the client?
- A. Take daily weights and monitor trends.
- B. Encourage fluid intake to improve hydration.
- C. Elevate the legs above the level of the heart.
- D. Position the client supine with the head of the bed at 30 degrees.
Correct Answer: A
Rationale: Elevated BNP levels are indicative of heart failure, which often causes fluid retention and weight gain. Taking daily weights and monitoring trends allows the nurse to assess for changes in fluid status. This intervention helps in evaluating the effectiveness of the treatment plan and identifying worsening heart failure symptoms early.
A client with myocardial infarction (MI) has been transferred from the coronary care unit (CCU) to the general medical unit with cardiac monitoring via telemetry. The nurse assisting in caring for the client expects to note which type of activity prescribed?
- A. Strict bed rest for 24 hours
- B. Bathroom privileges and self-care activities
- C. Unrestricted activities because the client is monitored
- D. Unsupervised hallway ambulation with distances less than 200 feet
Correct Answer: B
Rationale: After being transferred from the CCU to the general medical unit with cardiac monitoring, the client with MI is typically prescribed bathroom privileges and self-care activities. This allows for gradual recovery and mobility while still being closely monitored, promoting the client's overall well-being and independence.
The healthcare professional is collecting data on a client who was just admitted to the hospital with a diagnosis of coronary artery disease (CAD). The client reveals having been under a great deal of stress recently. What should the healthcare professional do next?
- A. Ask whether the client wants to seek counseling or therapy.
- B. Explore with the client the sources of stress in their life.
- C. Reassure the client that stress is common in today's world.
- D. Ask the client to make a list of stressors for later evaluation.
Correct Answer: B
Rationale: It is important for the healthcare professional to explore the sources of stress with the client to develop an effective stress management plan tailored to the individual's specific stressors. This approach can help in identifying triggers, implementing appropriate interventions, and supporting the client's overall well-being.