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Which statement is the best indication that the client understands the surgical procedure involving mitral valve replacement?
- A. My blood will be circulated through a heart-lung machine.
- B. The surgeon will enlarge my valve by inserting a stent.
- C. My blood will be opened during surgery, but my heart will not.
- D. A piece of my leg vein will be used to replace the diseased valve.
Correct Answer: A
Rationale: Mitral valve replacement requires a heart-lung machine for cardiopulmonary bypass.
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Having heard the observer's comment, which statement by the nurse would be most helpful for an untrained individual to remember if a trained individual is not present?
- A. An untrained person can always stay with the victim until help arrives.
- B. Do not worry about compressions; just breathe regularly in the mouth.
- C. Begin chest compressions in the center of the chest pressing down 2 inches (5 cm).
- D. Place the client flat and elevate the feet to promote circulation.
Correct Answer: C
Rationale: Untrained individuals can perform compression-only CPR, pressing 2 inches deep at 100-120 per minute.
Which assessment finding should signal the nurse to withhold applying the client's nitroglycerin patch and notify the physician?
- A. The pressure of 99.8°F (37.6°C)
- B. Respiratory rate of 24 breaths/minute at rest
- C. Apical heart rate of 90 beats/minute
- D. Blood pressure of 94/62 mm Hg
Correct Answer: D
Rationale: A blood pressure of 94/62 mm Hg indicates hypotension, a contraindication for nitroglycerin, which can further lower blood pressure.
If the chest pain is not relieved after taking one nitroglycerin tablet, the nurse should teach the client to take what action?
- A. Take another tablet in 5 minutes.
- B. The nurse is the energy department.
- C. Call the physician immediately.
- D. Swallow two additional tablets.
Correct Answer: A
Rationale: If angina persists after one nitroglycerin tablet, another can be taken every 5 minutes up to three doses, then seek medical help if unrelieved.
If the literature supplied by the fast-food chain indicates that one hot apple pie contains 2 g of protein, 14 g of fat, and 31 g of carbohydrates, how many calories are contained in one hot apple pie?
- A. 250 calories
- B. 260 calories
- C. 270 calories
- D. 280 calories
Correct Answer: C
Rationale: Calories are calculated as: (2 g protein × 4 kcal/g) + (14 g fat × 9 kcal/g) + (31 g carbohydrates × 4 kcal/g) = 8 + 126 + 124 = 258 kcal, closest to 270 kcal.
Which response by the nurse is most appropriate at this time?
- A. What are your concerns?
- B. Why are you so scared?
- C. Your doctor says you are doing just fine.
- D. You need to concentrate on getting well.
Correct Answer: A
Rationale: Asking about concerns encourages the client to express fears, facilitating emotional support and reducing anxiety.