Nokea
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.
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What should be included in foot care for the client who has a peripheral vascular disorder?
- A. Soaking the feet for 20 minutes before washing them
- B. Walking barefoot only on carpeted floors
- C. Applying lotion between the toes to avoid cracking of the skin
- D. Avoiding exposure of the legs and feet to the sun
Correct Answer: D
Rationale: Avoiding sun exposure prevents skin damage in clients with compromised circulation due to peripheral vascular disease. Soaking, walking barefoot, or applying lotion between toes increase infection or injury risk.
The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this client?
- A. Apical pulse rate of 110 and 4+ pitting edema of feet.
- B. Thick white sputum and crackles that clear with cough.
- C. The client sleeping with no pillow and eupnea.
- D. Radial pulse rate of 90 and CRT less than three (3) seconds.
Correct Answer: A
Rationale: CHF exacerbation causes fluid overload, leading to tachycardia (apical pulse 110) and severe edema (4+ pitting, A). Thick sputum/crackles (B) suggest pneumonia, sleeping flat with eupnea (C) is unlikely, and normal CRT (D) doesn’t reflect CHF severity.
A client who has been treated for angina is discharged in stable condition. At a clinic visit, he tells the nurse he has anginal pain when he has sexual intercourse with his wife. What is the best response for the nurse to make?
- A. Do you have ambivalent feelings toward your wife?'
- B. Many persons with angina have less pain when their partner assumes the top position.'
- C. Be sure that you attempt intercourse only when you are well rested and relaxed.'
- D. You might try having a cocktail before sexual activity to help you relax.'
Correct Answer: C
Rationale: Engaging in sexual activity when well-rested and relaxed reduces cardiac demand, minimizing angina risk. Questioning feelings, suggesting positions, or recommending alcohol are less appropriate or potentially harmful.
The elderly client has coronary artery disease. Which question should the nurse ask the client during the client teaching?
- A. Do you have a daily bowel movement?'
- B. Do you get yearly chest x-rays (CXRs)?'
- C. Are you sexually active?'
- D. Have you had any weight change?'
Correct Answer: D
Rationale: Weight change (D) may indicate fluid retention or malnutrition, relevant to CAD management. Bowel movements (A), CXRs (B), and sexual activity (C) are less directly related.
Which of the following electrocardiogram (ECG) changes supports the diagnosis that the client is experiencing a myocardial infarction (MI)?
- A. Inverted P wave
- B. Prolonged PR interval
- C. Widened QRS complex
- D. Elevated ST segment
Correct Answer: D
Rationale: ST-segment elevation on ECG is a hallmark of acute myocardial infarction, indicating myocardial ischemia.