Nokea
The nurse is teaching a client with cardiomyopathy about implantable cardioverter-defibrillators (ICDs). Which statement is accurate?
- A. It will prevent all arrhythmias.
- B. It delivers a shock if a dangerous rhythm occurs.
- C. It replaces the need for medications.
- D. It requires replacement every 2 years.
Correct Answer: B
Rationale: An ICD monitors heart rhythm and delivers a shock to restore normal rhythm in life-threatening arrhythmias.
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The client presents to the outpatient clinic complaining of calf pain. The client reports returning from an airplane trip the previous day. Which should the nurse assess first?
- A. The nurse should auscultate the lung fields and heart sounds.
- B. The nurse should determine the length of the airplane trip.
- C. The nurse should determine if the client has had chest pain.
- D. The nurse should measure the calf and palpate the calf for warmth.
Correct Answer: C
Rationale: Calf pain post-flight suggests DVT; assessing for chest pain (C) rules out pulmonary embolism, a priority. Lung/heart sounds (A), trip length (B), and calf exam (D) follow.
The nurse is caring for clients on a surgical floor. Which client should be assessed first?
- A. The client who is four (4) days postoperative abdominal surgery and is complaining of left calf pain when ambulating.
- B. The client who is one (1) day postoperative hernia repair who has just been able to void 550 mL of clear amber urine.
- C. The client who is five (5) days postoperative open cholecystectomy who has a T-tube and is being discharged.
- D. The client who is 16 hours post-abdominal hysterectomy and is complaining of abdominal pain and is expelling flatus.
Correct Answer: A
Rationale: Calf pain post-surgery (A) suggests DVT, requiring immediate assessment. Normal voiding (B), discharge (C), and expected pain/flatus (D) are less urgent.
The nurse is assessing a client with mitral regurgitation. Which finding is expected?
- A. High-pitched holosystolic murmur
- B. Bradycardia
- C. Clear lung sounds
- D. Hypotension
Correct Answer: A
Rationale: Mitral regurgitation causes a high-pitched holosystolic murmur due to blood flowing back into the left atrium.
The client is at risk for a myocardial infarction due to decreased tissue perfusion as a result of atherosclerosis. Which instructions can the nurse provide the client to reduce the risk?
- A. Teach the client to control the blood pressure to less than 140/90.
- B. Instruct the client to exercise 30 minutes a day three (3) times a week.
- C. Demonstrate how to take the blood pressure using a battery-operated cuff.
- D. Inform the client to limit fat intake and which foods have a higher fat content.
Correct Answer: A,B,D
Rationale: Controlling BP <140/90 (A), exercising 30 min 3×/week (B), and limiting fat (D) reduce MI risk. BP cuff use (C) is monitoring, not prevention.
The client tells the nurse that his cholesterol level is 240 mg/dL. Which action should the nurse implement?
- A. Praise the client for having a normal cholesterol level.
- B. Explain that the client needs to lower the cholesterol level.
- C. Discuss dietary changes that could help increase the level.
- D. Allow the client to ventilate feelings about the blood test result.
Correct Answer: B
Rationale: Cholesterol 240 mg/dL (B) is high (>200 is abnormal), requiring education to lower it. Praising (A) is incorrect, increasing (C) is harmful, and venting (D) is secondary.