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Which of the following symptoms should the nurse teach the client with unstable angina to report immediately to her physician?
- A. A change in the pattern of her pain.
- B. Pain during sexual activity.
- C. Pain during an argument with her husband.
- D. Pain during or after an activity such as lawn-mowing.
Correct Answer: A
Rationale: A change in the pattern of angina pain may indicate worsening ischemia or progression to unstable angina or MI, requiring immediate medical attention.
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The American Heart Association (AHA) guidelines urge greater availability of automated external defibrillators (AEDs) and people trained to use them. AEDs are used in cardiac arrest situations for:
- A. Early defibrillation in cases of atrial fibrillation.
- B. Cardiovascular placement.
- C. Early defibrillation in cases of ventricular fibrillation.
- D. None of the above
Correct Answer: C
Rationale: AEDs are used for early defibrillation in ventricular fibrillation or pulseless ventricular tachycardia, as these are shockable rhythms that can be corrected to restore cardiac function.
A 36-year-old female is complaining of increased vaginal dryness during sexual intercourse. She has received chemotherapy in the past and has menopausal symptoms due to ovarian suppression. An appropriate nursing intervention would be to instruct the client on the use of:
- A. Vaginal dilators.
- B. Nightly douches.
- C. Water-soluble vaginal lubricants.
- D. Relaxation techniques.
Correct Answer: C
Rationale: Water-soluble vaginal lubricants are effective for managing vaginal dryness caused by chemotherapy-induced ovarian suppression, improving comfort during intercourse.
Which of the following nursing interventions would be most helpful in making the respiratory effort of a client with metastatic lung cancer more efficient?
- A. Teaching the client diaphragmatic breathing techniques.
- B. Administering cough suppressants as ordered.
- C. Teaching and encouraging pursed-lip breathing.
- D. Placing the client in a low semi-Fowler's position.
Correct Answer: C
Rationale: Pursed-lip breathing helps prolong exhalation, reducing air trapping and improving respiratory efficiency in clients with metastatic lung cancer.
The nurse sees a client walking in the hallway who begins to have a seizure. The nurse should do which of the following in priority order?
- A. Maintain a patent airway.
- B. Record the seizure activity observed.
- C. Ease the client to the floor.
- D. Obtain vital signs.
Correct Answer: C,A,B,D
Rationale: The priority order is: 1) Ease the client to the floor to prevent injury (C); 2) Maintain a patent airway to ensure oxygenation (A); 3) Record seizure activity for accurate reporting (B); 4) Obtain vital signs post-seizure to assess stability (D).
The nurse is a member of a team that is planning a client-centered approach to care of clients with chronic obstructive pulmonary disease (COPD) using the Chronic Care Model (CCM). The team should focus on improving quality of care and delivery in which of the following areas? Select all that apply.
- A. The community.
- B. Clinical information systems.
- C. Delivery system design.
- D. Administrative leadership.
- E. Emphasis on the acute care setting.
Correct Answer: A,B,C
Rationale: The Chronic Care Model emphasizes community resources (A), clinical information systems (B), and delivery system design (C) for chronic disease management. Administrative leadership and acute care focus are less central.