Nokea
Which of the following information should the nurse include when teaching a client about congestive heart failure (CHF)? Select all that apply.
- A. Foods such as canned vegetables and luncheon meat should be avoided.
- B. Weigh yourself daily and notify the physician if the weight gain is more than ten pounds in a week.
- C. You may continue to take ibuprofen for your aches and pains.
- D. Annual immunizations such as the influenza vaccine are recommended.
- E. If you feel sick, you will need to check your urine for ketones.
Correct Answer: A,D
Rationale: High-sodium foods like canned vegetables and luncheon meat should be avoided to prevent fluid retention. B: Incorrect - Weight gain >2-3 lbs in a week is concerning, not 10 lbs. C: Incorrect - Ibuprofen can worsen heart failure. D: Correct - Influenza vaccine reduces infection risk, which can exacerbate heart failure. E: Incorrect - Checking urine for ketones is relevant for diabetes, not CHF.
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The nurse cares for a client with suspected congestive heart failure (CHF). Which of the following laboratory tests would the nurse expect the primary health care provider (PHCP) to prescribe to confirm the diagnosis?
- A. Basic metabolic panel (BMP)
- B. B-type natriuretic peptide (BNP)
- C. Complete Metabolic Profile (CMP)
- D. C-Reactive Protein (CRP)
Correct Answer: B
Rationale: BNP is a specific marker for heart failure, elevated due to ventricular strain.
Which of the following statements by the client with atrial fibrillation would require a follow-up? Select all that apply.
- A. I have an increased risk for a stroke.
- B. I should weigh myself daily at the same time.
- C. I may be prescribed medications such as amiodarone.
- D. I should wear a mask when I am in public.
- E. I should seek medical care if I develop shortness of breath.
Correct Answer: B,D
Rationale: Atrial fibrillation increases stroke risk due to clot formation; no follow-up needed. B: Incorrect - Daily weighing is more relevant for heart failure, not atrial fibrillation; requires clarification. C: Correct - Amiodarone is a common medication for atrial fibrillation; no follow-up needed. D: Incorrect - Wearing a mask in public is not related to atrial fibrillation management; requires clarification. E: Correct - Shortness of breath could indicate complications; no follow-up needed.
Which of the following would cause an increase in cardiac output? Select all that apply.
- A. Increased stroke volume
- B. Increased blood volume
- C. Increased sympathetic stimulation
- D. Administration of positive inotropic drugs
- E. Increased systemic vascular resistance (SVR)
Correct Answer: A,B,C,D
Rationale: Increased stroke volume directly increases cardiac output. Increased blood volume enhances preload, boosting output. C: Correct - Sympathetic stimulation increases heart rate and contractility. D: Correct - Positive inotropes enhance contractility, increasing output. E: Incorrect - Increased SVR increases afterload, reducing cardiac output.
The nurse is caring for a client with the below tracing on the electrocardiogram. The nurse should perform which priority action? See the image below.
- A. initiate a code blue.
- B. establish a peripheral vascular access device
- C. notify the primary healthcare physician (PHCP)
- D. assess the client's airway, breathing, and circulation
Correct Answer: D
Rationale: For any critical ECG tracing (e.g., ventricular fibrillation), assessing airway, breathing, and circulation (ABCs) is the priority to guide further interventions.
The nurse in the emergency department (ED) is assessing a client who may have an acute myocardial infarction. Which of the following findings would support this diagnosis?
- A. U-waves
- B. T-wave inversion
- C. ST-segment elevation
- D. Prolonged PR-interval
Correct Answer: C
Rationale: ST-segment elevation on ECG is a hallmark of acute myocardial infarction, indicating myocardial ischemia.