Nokea
The nurse is to administer 40 mg of furosemide to the client in HF. The prefilled syringe reads 100 mg/mL. In order to give the correct dose, how many milliliters should the nurse administer to the client?
Correct Answer: 0.4
Rationale: Use a proportion formula: 100 mg: 1 mL :: 40 mg: X mL; 100X = 40; X = 0.4. The nurse should administer 0.4 mL of furosemide.
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The nurse collects the following assessment data on the client who has no known health problems: BP 135/89 mm Hg; BMI 23; waist circumference 34 inches; serum creatinine 0.9 mg/dL; serum potassium 4.0 mEq/L; LDL cholesterol 200 mg/dL; HDL cholesterol 25 mg/dL; and triglycerides 180 mg/dL. Which intervention should the nurse anticipate?
- A. A low-calorie regular diet
- B. A statin antilipidemic medication
- C. A thiazide diuretic medication
- D. Low-salt, low-saturated-fat, low-potassium diet
Correct Answer: B
Rationale: A statin antilipidemic should be prescribed to manage the client’s hypercholesterolemia. It will lower the LDL cholesterol and triglycerides and increase the HDL cholesterol. A low-calorie diet is unnecessary with a normal BMI, a diuretic is not indicated for slightly elevated BP, and a low-potassium diet is not needed with normal potassium levels.
The client with class II HF according to the New York Heart Association Functional Classification has been taught about the initial treatment plan for this disease. The nurse determines that the client needs additional teaching if the client states that the treatment plan includes which component?
- A. Diuretics
- B. A low-sodium diet
- C. Home oxygen therapy
- D. Angiotensin-converting enzyme (ACE) inhibitors
Correct Answer: C
Rationale: In class II HF, normal physical activity results in fatigue, dyspnea, palpitations, or anginal pain, but symptoms are absent at rest. Home oxygen therapy is unnecessary unless there are other comorbid conditions. Diuretics, low-sodium diet, and ACE inhibitors are standard treatments.
The nurse is discussing healthy lifestyle practices with the client who has chronic venous insufficiency. Which practices should be emphasized with this client? Select all that apply.
- A. Avoid eating an excess of dark green vegetables.
- B. Take rests and elevate the legs while sitting.
- C. Wear graduated compression stockings, removing them at night.
- D. Increase standing time and shift weight when upright.
- E. Sleep with legs elevated above the level of the heart.
Correct Answer: B;C;E
Rationale: The nurse should emphasize: B) Elevating legs when sitting to promote venous return; C) Wearing compression stockings to reduce edema; E) Sleeping with legs elevated to enhance venous return. Avoiding dark green vegetables is relevant only with anticoagulants, and prolonged standing should be avoided.
The client’s BP is being taken at a screening clinic. Which client statement to the nurse demonstrates awareness of having a risk factor for hypertension?
- A. “My doctor told me my body mass index is 23 and my blood pressure is 118/70.”
- B. “I usually have a glass of wine to unwind when I come home from work.”
- C. “I plan to get my blood pressure checked more often, as I am African American.”
- D. “I have colds during the winter, so I plan to get the influenza vaccine every year.”
Correct Answer: C
Rationale: Being African American is a known risk factor for hypertension. Starting to have the BP taken more often demonstrates awareness of having a risk factor for hypertension. A BMI of 23 is normal, excessive alcohol intake increases risk but one glass is not excessive, and colds or flu vaccines do not directly relate to hypertension risk.
The client is scheduled for a coronary artery bypass graft in one week. Which instructions should the nurse provide to the client? Select all that apply.
- A. Stop taking aspirin now and any products containing aspirin.
- B. Do perform aerobic exercises 30 minutes daily before surgery.
- C. Use the prescribed antimicrobial soap before hospital arrival.
- D. Shave your chest and legs and then shower to remove the hair.
- E. Resume normal activities when discharged from the hospital.
Correct Answer: A;C
Rationale: The nurse should instruct: A) Stop aspirin to reduce bleeding risk; C) Use antimicrobial soap to decrease infection risk. Aerobic exercises (B) may be too strenuous, shaving (D) is done just before surgery, and normal activities (E) are restricted post-surgery.