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Which of the following dietary recommendations is the most appropriate to give a patient who has been diagnosed with CAD?
- A. 2500 calories daily, with 45% of diet consisting of simple carbohydrates
- B. Decreased intake of sodium, animal, other fats, overall calories, and increase dietary fiber.
- C. High-protein intake with limited dairy products, decreased sodium, potassium, and phosphorus.
Correct Answer: B
Rationale: This diet helps reduce cholesterol and blood pressure, which are critical for managing CAD.
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The nurse determines that the treatment of heart failure has been successful when the patient experiences
- A. Weight loss and diuresis
- B. Warm skin and less fatigue
- C. Clear lung sounds and decreased heart rate
- D. Absence of chest pain and improved LOC
Correct Answer: C
Rationale: Successful treatment of heart failure is indicated by an absence of symptoms of pulmonary edema and hypoxemia, such as clear lung sounds and a normal heart rate.
The client asks about side effects of taking digoxin. How does the nurse respond?
- A. Anorexia can be a side effect of digoxin.
- B. Tachycardia can be a side effect of digoxin.
- C. Constipation can be a side effect of digoxin.
- D. Urinary retention can be a side effect of digoxin.
Correct Answer: A
Rationale: The correct answer is A: Anorexia can be a side effect of digoxin. Digoxin is known to cause anorexia due to its impact on the gastrointestinal system. It can lead to nausea, vomiting, and loss of appetite, resulting in anorexia. Tachycardia (choice B) is not a common side effect of digoxin, as it is actually used to treat certain types of arrhythmias. Constipation (choice C) and urinary retention (choice D) are also not typically associated with digoxin use. In summary, anorexia is a known side effect of digoxin, while tachycardia, constipation, and urinary retention are not commonly linked to this medication.
At 9:00 pm, you admit a 63-year-old with a diagnosis of acute myocardial infarction (AMI) to the ED. The physician is considering the use of fibrinolytic therapy with tissue plasminogen activator (tPA, alteplase). Which information is most important to communicate to the physician?
- A. The patient was treated with alteplase about 8 months ago.
- B. The patient takes famotidine (Pepcid) for esophageal reflux.
- C. The patient has T wave inversions on the 12-lead ECG.
- D. The patient has had continuous chest pain since 1:00 pM.
Correct Answer: D
Rationale: Continuous chest pain indicates ongoing ischemia, making the patient a candidate for fibrinolytic therapy within the therapeutic window.
What is a surgical procedure where a blood vessel is grafted to bypass a blocked coronary artery, improving blood flow to the heart muscle?
- A. Coronary artery bypass graft (CABG)
- B. Valve replacement
- C. Angioplasty
- D. Endarterectomy
Correct Answer: A
Rationale: The correct answer is A: Coronary artery bypass graft (CABG). This surgical procedure involves grafting a blood vessel to bypass a blocked coronary artery, improving blood flow to the heart muscle. It is used to treat severe coronary artery disease. Valve replacement (B) is a surgery to replace heart valves, not to bypass blocked arteries. Angioplasty (C) involves inserting a balloon to widen a narrowed artery, not bypassing it. Endarterectomy (D) is a procedure to remove plaque from an artery, not bypassing a blocked coronary artery.
A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear on auscultation and slight pedal edema. The patient's medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5 lb (2.27 kg) weight gain over the past two days. The cardiac-vascular nurse's initial action is to:
- A. document the weight and reassess the patient at the next session.
- B. inquire about the patient's medication compliance.
- C. notify the patient's physician.
- D. review the patient's most recent nuclear scan.
Correct Answer: B
Rationale: Weight gain and pedal edema suggest fluid retention, so assessing medication compliance is essential.