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The nurse is reviewing laboratory data for a client suspected of having a myocardial infarction. The nurse anticipates that the CK-MB isoenzyme will peak within how many hours?
- A. 3 to 6 hours
- B. 1 to 2 hours
- C. 48 to 72 hours
- D. 18 hours
Correct Answer: D
Rationale: CK-MB peaks around 18 hours after a myocardial infarction, indicating myocardial damage.
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The nurse is assessing a client with congestive heart failure. Which physical assessment finding should the nurse expect?
- A. Intermittent claudication
- B. S3 gallop
- C. Venous stasis ulcers
- D. Widened pulse pressure
Correct Answer: B
Rationale: An S3 gallop is a common finding in CHF, indicating fluid overload and ventricular dysfunction.
The nurse is caring for a client who has been ordered a sodium-restricted diet following a myocardial infarction. Which of the following meals would be most appropriate to suggest?
- A. Turkey, 1 fresh sweet potato, 1/2 cup fresh green beans, milk, and 1 orange.
- B. Broiled fish, 1 baked potato, 1/2 cup canned beets, 1 orange, and milk.
- C. Canned salmon, fresh broccoli, 1 biscuit, tea, and 1 apple.
- D. A bologna sandwich, fresh eggplant, 2 oz fresh fruit, tea, and apple juice.
Correct Answer: A
Rationale: Fresh foods like turkey, sweet potato, and green beans are low in sodium, unlike canned or processed foods.
The nurse is caring for a client with the below tracing on the electrocardiogram. The nurse should expect the client to demonstrate which clinical manifestation in conjunction with this electrocardiogram tracing? See the exhibit.
- A. Jugular venous distention (JVD)
- B. Systolic murmur
- C. Irregular pulse
- D. Widened pulse pressure
Correct Answer: C
Rationale: An irregular ECG tracing, such as in atrial fibrillation, typically correlates with an irregular pulse due to inconsistent ventricular contractions.
It would be correct for the nurse to identify which cardiac dysrhythmias can reduce cardiac output. Select all that apply.
- A. Supraventricular tachycardia
- B. Sinus bradycardia
- C. Ventricular tachycardia
- D. Mobitz type II heart block
- E. Isolated premature atrial contraction (PAC)
Correct Answer: A,B,C,D
Rationale: Supraventricular tachycardia reduces filling time, lowering cardiac output. Sinus bradycardia decreases heart rate, reducing output. C: Correct - Ventricular tachycardia impairs effective pumping. D: Correct - Mobitz type II can cause missed beats, reducing output. E: Incorrect - Isolated PACs typically do not significantly affect cardiac output.
The following scenario applies to the next 1 items
The nurse in the emergency department is caring for a 58-year-old male client.
Item 1 of 1
History & Physical Vital Signs Laboratory
Physician: >
1600: 58-year-old client with a history of hypertension and diabetes mellitus (type one) reports headaches and elevated blood pressure. The client reported the headaches started one day ago and have worsened. The client reports not taking his prescribed medications because he lost his health insurance. His prescribed antihypertensive medications were clonidine and enalapril. The client has a flushed appearance on exam, endorses a generalized headache, and blurred vision.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
- A. Administer prescribed timolol ophthalmic
- B. Obtain hourly blood glucose levels
- C. Obtain a prescription for regular insulin infusion
- D. Position the client Semi-fowler's
- E. Administer prescribed nitroprusside
- F. Potential Conditions: Hypertensive Emergency
- G. Blood Pressure, Thiocyanate levels
Correct Answer: D,E,F,G
Rationale: The client is likely experiencing a hypertensive emergency due to elevated BP, headache, and blurred vision. Actions: E - Nitroprusside lowers BP rapidly; D - Semi-Fowler's position reduces cardiac workload. Parameters: Blood Pressure monitors treatment efficacy; Thiocyanate levels ensure nitroprusside safety.