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The spouse of a client who had an angioplasty following a heart attack says to the nurse, 'What is an angioplasty? It sounds like plastic surgery. My husband had a heart attack.' What information should be included in the nurse's response?
- A. An angioplasty repairs the heart damage caused by the heart attack.
- B. During an angioplasty, the physician creates a bypass around blocked arteries, increasing the blood flow to the heart muscle.
- C. Angioplasty is a diagnostic procedure to see if there are any blocked coronary arteries.
- D. During an angioplasty, the physician uses a balloon-tipped catheter to open up an artery that is blocked by a clot, thus increasing blood flow to the heart muscle.
Correct Answer: D
Rationale: An angioplasty is the insertion of a balloon-tipped catheter into a coronary artery. The balloon is inflated, opening up the artery and increasing blood flow through the coronary artery to the heart muscle. Angioplasty does not repair heart damage. A left heart cardiac catheterization is the diagnostic procedure that precedes angioplasty. Answer 2 describes a coronary artery bypass graft (CABG) procedure.
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An elderly client with osteoarthritis.
The homecare nurse is visiting an elderly client with osteoarthritis. It would be MOST important for the nurse to include which of the following instructions?
- A. Swimming is the only helpful exercise for osteoarthritis.
- B. Warm-up exercises should be done prior to exercising.
- C. Exercises should be done routinely, even if severe joint pain occurs.
- D. Isometric exercises are most helpful to prevent contractures.
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) swimming is only one helpful exercise (2) correct-warm-up or 'stretching' exercises should always be done to begin and end exercising (3) severely painful joints should not be exercised (4) isometric exercises do not involve joint movement
The nurse is to administer a nasogastric tube feeding to a client. Which action is essential prior to administering the feeding?
- A. Position the client in supine position.
- B. Aspirate contents from the nasogastric tube and check the pH.
- C. Check the client's vital signs.
- D. Ask the client if she feels full.
Correct Answer: B
Rationale: Aspirating and checking pH confirms nasogastric tube placement in the stomach, preventing aspiration during feeding.
The nurse is caring for an adult who had a cervical laminectomy this morning. After an uneventful stay in the postanesthesia care unit, the client is returned to the nursing care unit. How should the client be positioned immediately upon return?
- A. Supine
- B. Prone
- C. Semi-reclining
- D. Side-lying
Correct Answer: C
Rationale: Semi-reclining reduces neck strain and swelling post-cervical laminectomy, promoting comfort and healing. Supine or prone may increase pressure, and side-lying is less optimal.
A nurse is assessing a patient that has undergone a recent CABG. The nurse notices a mole with irregular edges with a bluish color. The nurse should:
- A. Recommend a dermatological consult to the MD.
- B. Note the location of the mole and contact the physician via the telephone.
- C. Note the location of the mole and follow-up with the attending physician via the medical record and phone call.
- D. Remove the mole with a sharp's debridement technique, following charge nurse approval.
Correct Answer: C
Rationale: Contacting the attending physician via the medical record is appropriate due to the possibility of melanoma.
The client asks the nurse how the health care provider could tell she was pregnant 'just by looking inside.' What is the best explanation by the nurse?
- A. Bluish coloration of the cervix and vaginal walls
- B. Pronounced softening of the cervix
- C. Clot of very thick mucous that obstructs the cervical canal
- D. Slight rotation of the uterus to the right
Correct Answer: A
Rationale: Chadwick's sign is a bluish-purple coloration of the cervix and vaginal walls, occurring at 4 weeks of pregnancy, that is caused by vasocongestion.