Nokea
A client asks the nurse about her beta-blockers medication effect to her angina.
What would be the nurse's response?
- A. Decrease cardiac output.
- B. Increase cardiac output.
- C. Decrease cardiac contractility.
- D. Increase cardiac contractility.
Correct Answer: C
Rationale: Beta-blockers decrease heart rate and cardiac contractility, reducing myocardial oxygen demand and relieving angina.
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A nurse is assessing a newborn who is 1 hour old. Which of the following findings should be reported to the healthcare provider? (Select all that apply)
- A. Respiratory rate of 50 breaths per minute
- B. Nasal flaring
- C. Grunting
- D. Temperature of 36.5°C (97.7°F)
Correct Answer: B,C
Rationale: Nasal flaring and grunting indicate respiratory distress, requiring immediate reporting. A respiratory rate of 50 and temperature of 36.5°C are normal for a newborn.
A 4-year-old child with Down syndrome is admitted to the hospital with pneumonia. She has a heart murmur and appears to be in respiratory distress. Her mother asks why her child has a heart murmur. What is the best nursing response?
- A. Because she has pneumonia, her heart is working harder and causes the murmur.'
- B. Heart murmurs come and go in children. It is not a great concern.'
- C. Because of the pneumonia, her ductus arteriosus is functioning again.'
- D. Heart defects are common in children with Down syndrome. Her illness may make the murmur louder.'
Correct Answer: D
Rationale: Congenital heart defects, like ventricular septal defects, are common in Down syndrome, and pneumonia may amplify a murmur due to increased cardiac workload.
The nurse is assessing a client with suspected rheumatoid arthritis. Which of the following findings would support this diagnosis?
- A. Morning stiffness lasting over 30 minutes.
- B. Heberden’s nodes on the fingers.
- C. Pain in a single joint after exercise.
- D. Fever and weight loss without joint pain.
Correct Answer: A
Rationale: Morning stiffness lasting over 30 minutes is a hallmark of rheumatoid arthritis due to synovial inflammation. Heberden’s nodes (B) indicate osteoarthritis, single-joint pain (C) suggests injury, and fever/weight loss (D) are nonspecific without joint involvement.
A patient with Alzheimer's disease is admitted with suspected dehydration after his daughter reports that he's refused to drink anything for the past 3 days.
Which lab result is most expected with dehydration?
- A. Urine specific gravity of 1.005.
- B. Serum sodium level of 150 mEq/L.
- C. Hematocrit of 38%
- D. Elevated WBC
Correct Answer: B
Rationale: Hypernatremia (elevated sodium) is expected in dehydration due to water loss.
The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?
- A. Report muscle weakness to the physician.
- B. Allow six months for the drug to take effect.
- C. Take the medication with fruit juice.
- D. Ask the doctor to perform a complete blood count prior to starting the medication.
Correct Answer: A
Rationale: The client taking antilipidemics should be encouraged to report muscle weakness because this is a sign of rhabdomyolysis. The medication takes effect within one month of beginning therapy, so answer B is incorrect. The medication should be taken with water. Fruit juice, particularly grapefruit juice, can decrease the drug's effectiveness, so answer C is incorrect. Liver function studies, not a CBC, should be checked prior to beginning the medication, so answer D is incorrect.