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Which of the following is an expected outcome for a client on the second day of hospitalization after a myocardial infarction (MI)? The client:
- A. Has severe chest pain.
- B. Can identify risk factors for MI.
- C. Agrees to participate in a cardiac rehabilitation walking program.
- D. Can perform personal self-care activities without pain.
Correct Answer: D
Rationale: By the second day post-MI, the client should be able to perform self-care activities without pain, indicating stabilization. Severe pain is not expected, and risk factor identification or rehabilitation planning may occur later.
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A client who weighs 187 lb has an order to receive enoxaparin (Lovenox) 1 mg/kg. This drug is available in a concentration of 30 mg/0.3 mL. What dose would the nurse administer in milliliters?
- A. 0.85 mL
- B. 0.9 mL
- C. 0.95 mL
- D. 1.0 mL
Correct Answer: A
Rationale: Calculation: 187 lb ÷ 2.2 = 85 kg. Dose = 85 kg × 1 mg/kg = 85 mg. Concentration = 30 mg/0.3 mL = 100 mg/mL. Volume = 85 mg ÷ 100 mg/mL = 0.85 mL. Thus, the nurse administers 0.85 mL.
The nurse is planning a community health class for older adults. Which topic should the nurse prioritize?
- A. discussing and preventing polypharmacy
- B. strategies to stay physically active
- C. staying socially engaged in the community
- D. recommended immunizations
Correct Answer: A
Rationale: Polypharmacy is a critical issue in older adults, increasing the risk of adverse drug events.
A client with acute renal failure has edema. The nurse should:
- A. Elevate the legs.
- B. Restrict fluids.
- C. Administer a diuretic.
- D. Increase sodium intake.
Correct Answer: B
Rationale: Fluid restriction helps manage edema in acute renal failure.
A client with bladder cancer has lost an estimated 500 mL blood in the urine. The client's hemoglobin is 8.0 g/dL, and the physician orders a unit of packed blood cells. To administer the packed red blood cells, the nurse should:
- A. Attach the packed cells to the existing 19G I.V. of normal saline solution using Y tubing.
- B. Start an additional 22G I.V. site because the packed blood cells must be given in a separate line.
- C. Attach the packed blood cells to the existing 22G I.V. of 5% dextrose using Y tubing.
- D. Start an additional I.V. access device with a 22G Intracath.
Correct Answer: A
Rationale: Packed red blood cells should be administered via a 19G I.V. with normal saline using Y tubing to prevent hemolysis, which can occur with dextrose solutions.
An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of:
- A. Left ventricular atrophy.
- B. Irregular heartbeats.
- C. Peripheral vascular occlusion.
- D. Pacemaker placement.
Correct Answer: A
Rationale: Aging leads to left ventricular atrophy, reducing cardiac reserve and impairing the heart's ability to respond to stress, unlike irregular heartbeats or pacemakers.