Nokea
The nurse knows that the client understands the physician's explanation of the PTCA procedure when the client makes which statement?
- A. A balloon-tipped catheter will be inserted into my coronary artery.
- B. A Teflon graft will be used to replace an area of my artery.
- C. A section of my leg vein will be grafted around a narrowed coronary artery.
- D. A battery-operated pacemaker will be implanted to maintain my heart rate.
Correct Answer: A
Rationale: PTCA involves inflating a balloon-tipped catheter to open a narrowed coronary artery, improving blood flow.
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The best evidence that the client is complying with the diet therapy is the report of using which type of fat for cooking?
- A. Melted margarine
- B. Clarified butter
- C. Cooking spray
- D. Liquid corn oil
Correct Answer: C
Rationale: Cooking spray is low in saturated fat and calories, aligning with a heart-healthy diet to control CAD progression.
To assess the area where the permanent pacemaker battery, the nurse knows to examine which area of the skin?
- A. Beneath the left nipple
- B. Near the brachial artery
- C. In the midsternal area
- D. Below the right clavicle
Correct Answer: D
Rationale: Pacemaker generators are typically implanted below the right clavicle.
The client diagnosed with a myocardial infarction is on bedrest. The unlicensed assistive personnel (UAP) is encouraging the client to move the legs. Which action should the nurse implement?
- A. Instruct the UAP to stop encouraging the leg movements.
- B. Report this behavior to the charge nurse as soon as possible.
- C. Praise the UAP for encouraging the client to move the legs.
- D. Take no action concerning the UAP's behavior.
Correct Answer: C
Rationale: Leg movements (C) prevent DVT in MI patients on bedrest, so praising the UAP is appropriate. Stopping (A), reporting (B), or ignoring (D) are incorrect.
An adult who is receiving heparin asks the nurse why it cannot be given by mouth. The nurse responds that heparin is given parenterally because:
- A. it is destroyed by gastric secretions.
- B. it irritates the gastric mucosa.
- C. it irritates the intestinal lining.
- D. therapeutic levels can be achieved more quickly.
Correct Answer: AUG
Rationale: Heparin is a protein and is destroyed by gastric secretions, requiring parenteral administration (intravenously or subcutaneously). It does not irritate the gastric or intestinal lining, and while parenteral administration allows faster therapeutic levels, the primary reason is its destruction in the stomach.
Which data would cause the nurse to question administering digoxin to a client diagnosed with congestive heart failure?
- A. The potassium level is 3.2 mEq/L.
- B. The digoxin level is 1.2 mcg/mL.
- C. The client's apical pulse is 64.
- D. The client denies yellow haze.
Correct Answer: A
Rationale: Hypokalemia (K+ 3.2, A) increases digoxin toxicity risk, warranting caution. Digoxin level 1.2 (B) is therapeutic, pulse 64 (C) is normal, and no yellow haze (D) is expected.