Nokea
The patient is experiencing chest pain and pain radiating to his arms, jaw, and back. The provider diagnosed his condition as a myocardial infarction. The patient asks what happened to him. The best response is:
- A. You cannot tell him what has happened; he needs to wait for the provider to return and explain what is going on currently.
- B. His aortic valve was malformed at birth causing a disruption in blood flow.
- C. All patients who are overweight like him will have a heart attack.
- D. One or more arteries that supply blood to his heart are blocked, thereby preventing an adequate amount of blood from getting to his cardiac muscles.
Correct Answer: D
Rationale: A myocardial infarction occurs when there is a blockage in one or more arteries supplying blood to the heart.
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The client is on spironolactone (Aldactone). What is the most important dietary instruction?
- A. Avoid foods high in potassium.
- B. Increase intake of foods high in potassium.
- C. Avoid foods high in sodium.
- D. Increase intake of foods high in sodium.
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic that can increase potassium levels in the body. Consuming foods high in potassium while on spironolactone can lead to hyperkalemia, which can be dangerous. By avoiding foods high in potassium, the client can help maintain a safe potassium level.
Summary:
- Choice B (Increase intake of foods high in potassium) is incorrect because it can lead to hyperkalemia when combined with spironolactone.
- Choice C (Avoid foods high in sodium) is unrelated to spironolactone's mechanism of action.
- Choice D (Increase intake of foods high in sodium) is incorrect as it is not relevant to the dietary instruction needed for a client on spironolactone.
A long-term-care resident with venous stasis ulcers is treated with Unna's boot. Which of the nursing activities included in the resident's care is best for you to delegate to a nursing assistant?
- A. Monitor capillary perfusion once every 8 hours.
- B. Teach family members the signs of infection.
- C. Evaluate foot sensation and movement each shift.
- D. Assist patient with cleaning around Unna's boot.
Correct Answer: D
Rationale: Cleaning around the boot is a simple task suitable for a nursing assistant.
What is a condition where the blood pressure in the arteries is consistently too high, increasing the risk of heart disease and stroke?
- A. Hypertension
- B. Hypotension
- C. Diabetes
- D. Hyperlipidemia
Correct Answer: A
Rationale: Step-by-step rationale:
1. Hypertension is defined as consistently high blood pressure, a major risk factor for heart disease and stroke.
2. Hypotension is low blood pressure, not associated with increased risk of heart disease or stroke.
3. Diabetes is a metabolic disorder, not directly related to blood pressure.
4. Hyperlipidemia is high levels of fats in the blood, which can contribute to heart disease but not specifically related to high blood pressure.
Summary:
Hypertension is the correct answer because it specifically refers to high blood pressure, a significant risk factor for heart disease and stroke. Hypotension, diabetes, and hyperlipidemia are incorrect as they do not directly cause consistently high blood pressure.
What is the primary consideration when preparing to administer thrombolytic therapy to a patient who is experiencing an acute myocardial infarction (MI)?
- A. History of heart disease.
- B. Sensitivity to aspirin.
- C. Size and location of the MI.
- D. Time since onset of symptoms.
Correct Answer: D
Rationale: Thrombolytic therapy is most effective when administered within a few hours of symptom onset.
What is the condition where the heart's mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle?
- A. Mitral stenosis
- B. Aortic stenosis
- C. Tricuspid regurgitation
- D. Pulmonary hypertension
Correct Answer: A
Rationale: The correct answer is A: Mitral stenosis. Mitral stenosis refers to the narrowing of the mitral valve, which obstructs blood flow from the left atrium to the left ventricle. This condition leads to increased pressure in the left atrium and lungs, causing symptoms like shortness of breath and fatigue.
Explanation:
1. Mitral stenosis specifically involves the mitral valve, not the aortic valve (B) or the tricuspid valve (C).
2. Tricuspid regurgitation (C) involves leakage of blood backward through the tricuspid valve, not narrowing.
3. Pulmonary hypertension (D) is a condition characterized by high blood pressure in the arteries of the lungs due to various causes, not specifically related to mitral valve narrowing.