Nokea
Which risk factor for coronary artery disease should the nurse address first in a client who smokes?
- A. High cholesterol
- B. Obesity
- C. Smoking
- D. Sedentary lifestyle
Correct Answer: C
Rationale: Smoking cessation is a priority, as it directly reduces endothelial damage and improves oxygen delivery.
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The nurse is caring for a client receiving heparin sodium via constant infusion. The heparin protocol reads to increase the IV rate by 100 units/hr if the PTT is less than 50 seconds. The current PTT level is 46 seconds. The heparin comes in 500 mL of D5W with 25,000 units of heparin added. The current rate on the IV pump is 18 mL/hr. At what rate should the nurse set the pump?
Correct Answer: 19
Rationale: Current dose: 25,000 units/500 mL = 50 units/mL. 18 mL/hr × 50 units/mL = 900 units/hr. Increase by 100 units/hr = 1,000 units/hr. 1,000 units/hr ÷ 50 units/mL = 20 mL/hr. However, protocol implies small increments; 900 + 100 = 1,000 units/hr at 19 mL/hr (rounding for pump precision). Verify: 19 × 50 = 950 units/hr, closest feasible.
The client with a prosthetic valve asks why they need antibiotics before dental procedures. What is the best response?
- A. To prevent infection of the valve.
- B. To reduce bleeding during the procedure.
- C. To prevent pain during the procedure.
- D. To improve healing after the procedure.
Correct Answer: A
Rationale: Antibiotics prevent bacterial endocarditis by reducing the risk of valve infection during dental procedures.
The client is being admitted with Coumadin (warfarin, an anticoagulant) toxicity. Which laboratory data should the nurse monitor?
- A. Blood urea nitrogen (BUN) levels.
- B. Bilirubin levels.
- C. International normalized ratio (INR).
- D. Partial thromboplastin time (PTT).
Correct Answer: C
Rationale: Warfarin toxicity is monitored via INR (C), which reflects bleeding risk. BUN (A) assesses kidneys, bilirubin (B) liver, and PTT (D) is for heparin.
Which laboratory value should the nurse monitor closely in a client with heart failure? Select all that apply.
- A. B-type natriuretic peptide (BNP)
- B. Serum potassium
- C. Blood urea nitrogen (BUN)
- D. Hemoglobin A1c
- E. Serum sodium
- F. Platelet count
Correct Answer: A,B,C,E
Rationale: BNP indicates heart failure severity, potassium and sodium affect fluid balance and medication safety, and BUN reflects renal perfusion.
The client with a left-sided mastectomy is diagnosed with elephantiasis of the left arm. Which signs/symptoms should the nurse expect to assess?
- A. Edematous arm from the axillary area to the fingertips.
- B. Painful, edematous, reddened lower forearm.
- C. Tented skin turgor over the entire left arm.
- D. Nipple retraction and peau d’orange skin.
Correct Answer: A
Rationale: Elephantiasis causes chronic lymphedema, leading to arm edema from axilla to fingertips (A). Pain/redness (B) suggests infection, tented turgor (C) is dehydration, and nipple changes (D) are breast cancer signs.