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Which of the following teaching topics should the nurse prioritize when educating staff about caring for a client with a pacemaker? Select all that apply.
- A. Understanding the indications for pacemaker placement.
- B. Recognizing signs of pacemaker malfunction.
- C. Explaining different types of pacemakers and how they function.
- D. Advising clients with pacemakers to avoid all sources of electromagnetic fields (EMFs).
- E. Discussing the importance of regular pacemaker check-ups and follow-up care.
- F. Providing guidelines on safe physical activities and exercise after pacemaker placement
Correct Answer: A,B,C,E,F
Rationale: Understanding indications helps staff anticipate client needs. Recognizing malfunction signs ensures timely intervention. C: Correct - Knowing pacemaker types aids in proper care. D: Incorrect - Avoiding all EMFs is overly restrictive; modern pacemakers are shielded. E: Correct - Regular check-ups ensure device functionality. F: Correct - Safe activity guidelines prevent complications.
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The nurse is caring for a client with the following clinical data. Based on the laboratory tests, which medication would the nurse clarify with the primary healthcare provider (PHCP) prior to administration? See the exhibit for additional client information.
- A. bupropion 150 mg XL PO Daily
- B. clonidine 0.1 mg PO Daily
- C. albuterol 2.5 mg via nebulizer Daily
- D. captopril 12.5 mg PO Daily
Correct Answer: D
Rationale: Captopril, an ACE inhibitor, requires clarification if renal function is impaired (e.g., elevated creatinine), as it can worsen kidney injury.
Which of the following should the nurse do for a client reporting chest pain radiating to the arm? Select all that apply.
- A. Obtain an electrocardiogram (ECG)
- B. Prepare the client for cardioversion
- C. Establish intravenous (IV) access
- D. Insert an indwelling urinary catheter
- E. Administer prescribed nitroglycerin
Correct Answer: A,C,E
Rationale: ECG is critical to diagnose the cause of chest pain. B: Incorrect - Cardioversion is for specific arrhythmias, not chest pain alone. C: Correct - IV access is needed for potential medications. D: Incorrect - Urinary catheter is not indicated for chest pain. E: Correct - Nitroglycerin relieves ischemic chest pain.
Which of the following statements about sodium are true for a client newly diagnosed with hypertension? Select all that apply.
- A. Sodium cannot be completely eliminated from the diet.
- B. There is no sodium in fresh fruits and vegetables.
- C. Canned vegetables should be avoided.
- D. The body needs some sodium as it plays an important role in water balance.
- E. Reduce daily sodium intake to 2,000 mg
Correct Answer: A,C,D
Rationale: Sodium is naturally present in many foods, making complete elimination impossible. B: Incorrect - Fresh fruits and vegetables contain small amounts of sodium naturally. C: Correct - Canned vegetables are high in sodium and should be avoided or rinsed. D: Correct - Sodium is essential for fluid balance and nerve function. E: Incorrect - Guidelines recommend reducing sodium to 1,500 mg/day for hypertension, not 2,000 mg.
An emergency department nurse is caring for a client who presented with fatigue, muscular weakness, and dyspnea. Upon assessment, the client was noted to be coughing frequently and sitting in a tripod position. A subsequent diagnosis of left ventricular failure was made. The nurse understands that manifestations of left-sided heart failure present as respiratory issues because:
- A. There is venous congestion in the liver.
- B. There is hypoperfusion of tissue cells.
- C. There is pulmonary congestion.
- D. Despite normal cardiac output, the heart cannot meet the accelerated demands of the body.
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, leading to respiratory symptoms like dyspnea and cough.
The nurse assists the code team with an unresponsive and pulseless client. Which intervention does the nurse prepare for based on the electrocardiogram (ECG) tracing? See the image below.
- A. Prepare an infusion of sodium bicarbonate
- B. Administer epinephrine
- C. Defibrillation
- D. Cardioversion
Correct Answer: C
Rationale: Defibrillation is the treatment for pulseless ventricular fibrillation or ventricular tachycardia, per ACLS guidelines.