Nokea
Which medical client problem should the nurse include in the plan of care for a client diagnosed with cardiomyopathy?
- A. Heart failure.
- B. Activity intolerance.
- C. Powerlessness.
- D. Anticipatory grieving.
Correct Answer: A
Rationale: Cardiomyopathy impairs cardiac function, leading to heart failure (A) as the primary medical problem. Activity intolerance (B), powerlessness (C), and grieving (D) are secondary psychosocial issues.
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The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?
- A. The client with three (3) unifocal PVCs in one (1) minute.
- B. The client diagnosed with coronary artery disease who wants to ambulate.
- C. The client diagnosed with mitral valve prolapse with an audible S3.
- D. The client diagnosed with pericarditis who is in normal sinus rhythm.
Correct Answer: C
Rationale: An S3 in mitral valve prolapse (C) suggests heart failure, requiring immediate assessment. Unifocal PVCs (A) are less urgent, ambulation (B) is routine, and normal rhythm in pericarditis (D) is stable.
The client diagnosed with congestive heart failure is complaining of leg cramps at night. Which nursing interventions should be implemented?
- A. Check the client for peripheral edema and make sure the client takes a diuretic early in the day.
- B. Monitor the client's potassium level and assess the client's intake of bananas and orange juice.
- C. Determine if the client has gained weight and instruct the client to keep the legs elevated.
- D. Instruct the client to ambulate frequently and perform calf-muscle stretching exercises daily.
Correct Answer: B
Rationale: Leg cramps in CHF may indicate hypokalemia from diuretics. Monitoring potassium and assessing potassium-rich food intake (B) is appropriate. Edema/diuretic timing (A), weight/elevation (C), and ambulation/stretching (D) are less directly related.
The client is admitted to the emergency department, and the nurse suspects a cardiac problem. Which assessment interventions should the nurse implement? Select all that apply.
- A. Obtain a midstream urine specimen.
- B. Attach the telemetry monitor to the client.
- C. Start a saline lock in the right arm.
- D. Draw a basal metabolic panel (BMP).
- E. Request an order for a STAT 12-lead ECG.
Correct Answer: B,C,E
Rationale: Telemetry (B), saline lock (C), and STAT ECG (E) assess cardiac status. Urine specimen (A) and BMP (D) are not priority for suspected cardiac issues.
The client who has had a myocardial infarction is admitted to the telemetry unit from intensive care. Which referral would be most appropriate for the client?
- A. Social worker.
- B. Physical therapy.
- C. Cardiac rehabilitation.
- D. Occupational therapy.
Correct Answer: C
Rationale: Cardiac rehabilitation (C) promotes recovery through exercise and education post-MI. Social work (A), physical therapy (B), and occupational therapy (D) are less specific.
Which population is at a higher risk for dying from a myocardial infarction?
- A. Caucasian males.
- B. Hispanic females.
- C. Asian males.
- D. African American females.
Correct Answer: D
Rationale: African American females (D) have higher MI mortality rates due to increased prevalence of risk factors like hypertension and diabetes, and disparities in healthcare access. Caucasian males (A), Hispanic females (B), and Asian males (C) have lower relative risk.