Nokea
The nurse is teaching a client with coronary artery disease (CAD) about the risk factors for the disease. Which modifiable risk factor should the nurse emphasize?
- A. Family history
- B. Age
- C. Cigarette smoking
- D. Gender
Correct Answer: C
Rationale: Cigarette smoking is a modifiable risk factor for coronary artery disease (CAD) because it can be changed or controlled to reduce the risk of developing CAD. Family history, age, and gender are non-modifiable risk factors, meaning they cannot be changed. By emphasizing the importance of quitting smoking, the nurse can help the client reduce their risk of CAD and improve their overall cardiovascular health.
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A client with a diagnosis of angina pectoris is prescribed nitroglycerin tablets. How should the nurse instruct the client to take the medication?
- A. Swallow the tablet whole with water
- B. Place the tablet under the tongue and let it dissolve
- C. Chew the tablet and then swallow
- D. Place the tablet between the cheek and gum
Correct Answer: B
Rationale: Nitroglycerin is most effective when administered sublingually (under the tongue) as it is rapidly absorbed into the bloodstream. Placing the tablet under the tongue allows for quick absorption and faster relief of angina symptoms. Chewing the tablet, swallowing it, or placing it between the cheek and gum would not provide the same rapid onset of action needed during an angina episode.
A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor the client for which potential electrolyte imbalance?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypocalcemia
Correct Answer: C
Rationale: When a client with heart failure is prescribed furosemide, the nurse should monitor for hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, which increases the risk of hypokalemia. Hypokalemia can have serious implications such as cardiac dysrhythmias. Therefore, it is essential to closely monitor the client's serum potassium levels while on furosemide to prevent complications.
A client with a history of deep vein thrombosis (DVT) is prescribed warfarin (Coumadin). The nurse should include which instruction in the discharge teaching?
- A. Take the medication at the same time each day
- B. Avoid green leafy vegetables in your diet
- C. Increase your intake of vitamin K-rich foods
- D. Stop the medication if you notice any bruising
Correct Answer: A
Rationale: Taking warfarin at the same time each day is crucial to maintain consistent blood levels and ensure the effectiveness of the medication in preventing clot formation. Consistent timing helps in monitoring and adjusting the dosage as needed to keep the international normalized ratio (INR) within the therapeutic range to prevent clotting events or excessive bleeding.
The healthcare professional is caring for a client who has just returned from a cardiac catheterization. The healthcare professional should prioritize which assessment?
- A. Monitoring the client's vital signs every 4 hours
- B. Assessing the puncture site for bleeding
- C. Encouraging the client to ambulate early to prevent complications
- D. Providing the client with fluids to flush out the contrast dye
Correct Answer: B
Rationale: Assessing the puncture site for bleeding is a critical assessment after a cardiac catheterization procedure. This is essential to detect and address any potential complications promptly, such as hemorrhage or hematoma formation. Monitoring the puncture site helps ensure early intervention and prevent further complications, making it the priority assessment in this situation.
A client with a diagnosis of heart failure is being discharged. What information should the nurse emphasize to the client regarding the use of a daily weight log?
- A. Report any weight gain of more than 2 pounds in a day
- B. Weigh yourself after eating breakfast each morning
- C. Use the same scale each day to check your weight
- D. Record your weight daily and report any changes
Correct Answer: A
Rationale: The correct answer is A: 'Report any weight gain of more than 2 pounds in a day.' Sudden weight gain of more than 2 pounds in a day may indicate fluid retention and worsening heart failure. This information is crucial for early intervention and monitoring of the client's condition. Weighing after eating breakfast (choice B) may not provide consistent results due to varying food and fluid intake. Using the same scale each day (choice C) ensures accuracy and consistency in weight measurements. Recording weight daily (choice D) is more frequent than necessary and may not be practical for all clients, making it important to focus on significant weight changes instead.