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The nurse should be prepared to obtain which prescription from the primary healthcare provider for a client with an oral temperature of 101 ° F (38.3° C) and an ECG tracing? Select all that apply.
- A. 0.9% saline bolus
- B. Enalapril
- C. Levothyroxine
- D. Metoclopramide
- E. Acetaminophen
Correct Answer: E
Rationale: Saline bolus is not indicated for fever alone without dehydration. B: Incorrect - Enalapril is for hypertension or heart failure, not fever or ECG issues. C: Incorrect - Levothyroxine is for hypothyroidism, not relevant here. D: Incorrect - Metoclopramide is for nausea, not fever or cardiac issues. E: Correct - Acetaminophen is appropriate for fever reduction.
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The nurse assessed a client's cardiac rhythm strip. The nurse should plan to document this rhythm as which of the following? See the image below.
- A. Ventricular fibrillation
- B. Complete (3rd degree) heart block
- C. Sinus tachycardia
- D. Sinus bradycardia
Correct Answer: A
Rationale: Ventricular fibrillation is a chaotic, life-threatening rhythm requiring immediate defibrillation.
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.
The following scenario applies to the next 6 items
The client is a 72-year-old male who presents to the emergency department with increasing
shortness of breath over the past two days that gets worse when he is lying flat in bed at night.
Item 1 of 6
History And Physical Nurses' Notes Flow Sheet
0700: The client is a 72-year-old male who presents to the emergency department with increasing shortness of breath over the past two days that gets worse when he is lying flat in bed at night. He states, "I feel like I can't catch my breath," and he had to sleep in a recliner. He reports a 4 lb weight gain over the last week and increasing fatigue. The client is alert and oriented but is using his accessory muscles to breathe. He reports feeling short of breath, orthopnea, and paroxysmal nocturnal dyspnea. He has bilateral pedal edema (+2), bilateral crackles heard upon auscultation, and jugular vein distention noted on his assessment. The
the client has a medical history of hypertension, coronary artery disease, and a prior myocardial infarction. He was diagnosed with heart failure with reduced ejection fraction (HFrEF) two years ago. Current home medications include lisinopril, metoprolol succinate, furosemide, and atorvastatin.
The nurse knows that the priority concept associated with the client's condition is ………….caused by a reduction in…………
- A. Oxygenation
- B. Perfusion
- C. Gas exchange
- D. Cardiac output
- E. Hemoglobin concentration
- F. Fluid balance
Correct Answer: B,D
Rationale: Heart failure is primarily a condition of reduced perfusion (B) due to decreased cardiac output (D), impairing the heart's ability to pump blood effectively.
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.
The nurse is caring for a client newly admitted with infective endocarditis (IE). The nurse should plan for which intervention in the client's care plan?
- A. initiating contact and droplet precautions
- B. obtain a prescription for intravenous antivirals
- C. obtain a prescription for enoxaparin
- D. monitor renal function
Correct Answer: D
Rationale: Infective endocarditis can cause glomerulonephritis, necessitating renal function monitoring (e.g., creatinine levels).