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When the client asks why the physician ordered the ECG, how does the nurse correctly explain its purpose?
- A. It will show how the heart performs during exercise.
- B. It will determine the client's potential target heart rate.
- C. It will verify how much the client needs to improve fitness.
- D. It will help predict whether the client will have a heart attack soon.
Correct Answer: A
Rationale: A stress ECG evaluates heart function under physical stress, detecting ischemia or abnormal rhythms indicative of coronary artery disease.
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The charge nurse is making shift assignments for the medical floor. Which client should be assigned to the most experienced registered nurse?
- A. The client diagnosed with congestive heart failure who is being discharged in the morning.
- B. The client who is having frequent incontinent liquid bowel movements and vomiting.
- C. The client with an apical pulse rate of 116, a respiratory rate of 26, and a blood pressure of 94/62.
- D. The client who is complaining of chest pain on inspiration and a nonproductive cough.
Correct Answer: C
Rationale: Tachycardia, tachypnea, and hypotension (C) suggest instability, requiring experienced nursing care. Discharging CHF (A), incontinence/vomiting (B), and pleuritic pain (D) are less acute.
Which action by a newly hired nursing assistant indicates that the nurse needs to provide more instruction to the nursing assistant on how to accurately assess the client's pulse rate?
- A. The nursing assistant places a thumb over the radial artery.
- B. The nursing assistant counts the pulse rate for 1 full minute.
- C. The nursing assistant rests the client's arm on the abdomen.
- D. The nursing assistant presses the radial artery against the bone.
Correct Answer: A
Rationale: Using the thumb to check the pulse can result in counting the assistant's own pulse, leading to inaccurate readings.
A female client is admitted to the hospital with obesity and deep vein thrombophlebitis (DVT) of the right leg. She weighs 275 pounds. Which of the following factors is least related to her diagnosis?
- A. She has been taking oral estrogens for the last three years.
- B. She smokes two packs of cigarettes daily.
- C. Her right femur was fractured recently.
- D. She is 30 years old.
Correct Answer: D
Rationale: Age (30 years) is the least related to DVT risk compared to estrogen use, smoking, and recent fracture, which are known risk factors for thrombosis.
Which interventions should the nurse discuss with the client diagnosed with coronary artery disease? Select all that apply.
- A. Instruct the client to stop smoking.
- B. Encourage the client to exercise three (3) days a week.
- C. Teach about coronary vasodilators.
- D. Prepare the client for a carotid endarterectomy.
- E. Eat foods high in monosaturated fats.
Correct Answer: A,B,C
Rationale: Stopping smoking (A), exercising (B), and vasodilators (C) reduce CAD progression. Carotid endarterectomy (D) is for stroke risk, and monounsaturated fats (E) are beneficial but not high amounts.
Using the following cardiac structures, trace the normal stress in which blood circulates on the left side of the heart. Use all the options.
- A. Aorta
- B. Left ventricle
- C. Pulmonary veins
- D. Left atrium
- E. Mitral valve (correct sequence: 3, 4, 5, 2, 1)
Correct Answer: D
Rationale: Blood flows: pulmonary veins → left atrium → mitral valve → left ventricle → aorta.