Nokea
Which effects contribute to making nitrates the first-line therapy for the treatment of angina (select one that doesn't apply?
- A. Decrease heart rate (HR)
- B. Prevent thrombosis of plaques
- C. Decrease myocardial contractility
- D. Dilate coronary arteries
Correct Answer: D
Rationale: Nitrates reduce preload and dilate coronary arteries.
You may also like to solve these questions
A patient is admitted to your acute coronary care unit with the diagnosis of ACS. The nurse has seen ECG changes that are indicative of an anterior wall infarction and is observing the patient for signs/symptoms of complications. The nurse has noted the following vital sign trends: 1100-HR 92, RR 24, BP 140/88, Cardiac rhythm NSR 1115-HR 96, RR 26, BP 128/82, Cardiac rhythm NSR 1130-HR 104, RR 28, BP 102/68, Cardiac rhythm ST 1145-HR 120, RR 32, BP 80/52, Cardiac rhythm ST with frequent PVC's The nurse should be alert for which of the following complications? Choose all that apply.
- A. Syncope
- B. Pericarditis
- C. Cardiogenic shock
- D. Cardiac tamponade
Correct Answer: C
Rationale: The correct answer is C - Cardiogenic shock. In this scenario, the vital sign trends indicate a progressive decline in blood pressure (BP) along with an increasing heart rate (HR) and respiratory rate (RR), which are signs of hemodynamic instability. Cardiogenic shock is a serious complication of acute coronary syndrome (ACS) and occurs when the heart is unable to pump enough blood to meet the body's demands. The decreasing BP and increasing HR in this patient suggest a failing cardiac output, leading to inadequate tissue perfusion and subsequent shock. Syncope (choice A) is possible but less likely given the progressive decline in vital signs. Pericarditis (choice B) typically presents with chest pain and ECG changes different from those seen in this case. Cardiac tamponade (choice D) is characterized by Beck's triad (muffled heart sounds, hypotension, and jugular venous distention), which is not evident in the vital sign trends provided.
Delegation Decision: The unit is very busy and short staffed. What could be delegated to the unlicensed assistive personnel (UAP)?
- A. Administer antihypertensive medications to stable patients
- B. Obtain orthostatic blood pressure (BP) readings for older patients
- C. Check BP readings for the patient receiving IV enalapril (Vasotec)
- D. Teach about home BP monitoring and use of automatic BP monitoring equipment
Correct Answer: B
Rationale: UAPs can perform routine tasks like orthostatic BP checks.
The registered nurse has finished reviewing the 7:00 a.m shift report on a telemetry unit. Which of the following clients would be the best for the RN to assign to the licensed practical nurse?
- A. A 7-day postoperative CABG client with an infection in the sternal surgical incision, requiring dressings and irrigation.
- B. A client who has just arrived on the unit from the emergency room for observation to rule out a myocardial infarction.
- C. A client who has had successful valve replacement therapy and will be discharged this morning.
- D. A client who is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) at 10:00 a.m.
Correct Answer: A
Rationale: The correct answer is A because the 7-day postoperative CABG client with an infection in the sternal surgical incision requires ongoing wound care with dressings and irrigation. This assignment is suitable for an LPN due to their skill level in wound care. Choice B is incorrect because a client being observed for a myocardial infarction requires close monitoring by an RN. Choice C is incorrect because a client being discharged soon requires coordination and paperwork, which is typically done by an RN. Choice D is incorrect because a client scheduled for a PTCA procedure requires pre-procedure assessments and care typically done by an RN. Thus, choice A is the best option for an LPN assignment.
A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include:
- A. Sunken eyeballs and poor skin turgor
- B. Thirst or confusion
- C. Increase heart rate with hypotension
- D. Coma or seizures
Correct Answer: A
Rationale: The correct answer is A. In the early stages of dehydration, the body tries to conserve water, leading to sunken eyeballs due to decreased fluid volume and poor skin turgor as skin loses its elasticity. Thirst or confusion (choice B) occur in moderate dehydration. Increased heart rate with hypotension (choice C) is a sign of severe dehydration. Coma or seizures (choice D) are extreme manifestations of dehydration and do not typically occur in the early stages.
The client is being fitted for a Holter Monitor. What does the nurse tell the client in preparation for the test?
- A. The client should lie motionless for the test.
- B. The client can shower but cannot bathe.
- C. The test will take about 30 minutes.
- D. The client should record the time of any palpable events, such as palpitations.
Correct Answer: D
Rationale: The correct answer is D because the client should record the time of any palpable events, such as palpitations, during the Holter Monitor test to correlate symptoms with the recorded heart rhythm. This information helps healthcare providers make an accurate diagnosis. Choice A is incorrect as the client can go about their usual activities during the test. Choice B is incorrect as the client can bathe normally while wearing the Holter monitor. Choice C is incorrect as the test typically lasts for 24 to 48 hours, not just 30 minutes.