Nokea
While the client takes propranolol (Inderal), what changes would the nurse expect to see in the client's pulse rate?
- A. Faster than usual
- B. No longer detectable
- C. Temporarily irregular
- D. Slower than in the past
Correct Answer: D
Rationale: Propranolol slows the heart rate by blocking beta-adrenergic receptors, reducing sympathetic stimulation.
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Which data would cause the nurse to question administering digoxin to a client diagnosed with congestive heart failure?
- A. The potassium level is 3.2 mEq/L.
- B. The digoxin level is 1.2 mcg/mL.
- C. The client's apical pulse is 64.
- D. The client denies yellow haze.
Correct Answer: A
Rationale: Hypokalemia (K+ 3.2, A) increases digoxin toxicity risk, warranting caution. Digoxin level 1.2 (B) is therapeutic, pulse 64 (C) is normal, and no yellow haze (D) is expected.
Because the client is exhibiting signs and symptoms of congestive heart failure (CHF), which position suggested by the nurse is most beneficial for the client at this time?
- A. Supine with knees slightly bent
- B. Side-lying on the right side
- C. Side-lying on the left side
- D. Semi-Fowler's position
Correct Answer: D
Rationale: Semi-Fowler's position (30-45 degrees) reduces preload and eases breathing in CHF.
Which intervention should the nurse implement with the client diagnosed with dilated cardiomyopathy?
- A. Keep the client in the supine position with the legs elevated.
- B. Discuss a heart transplant, which is the definitive treatment.
- C. Prepare the client for coronary artery bypass graft.
- D. Teach the client to take a calcium channel blocker in the morning.
Correct Answer: B
Rationale: Dilated cardiomyopathy may require heart transplant (B) as definitive treatment in severe cases. Supine position (A) increases preload, CABG (C) is for CAD, and calcium channel blockers (D) are not first-line.
Which nursing action is most appropriate when applying a new transdermal patient?
- A. Rotate the application site.
- B. Clean the skin with alcohol.
- C. Tape the patch to the client's chest.
- D. Take the blood pressure afterward.
Correct Answer: A
Rationale: Rotating the application site for a nitroglycerin patch prevents skin irritation and ensures consistent drug absorption.
Using the following cardiac structures, trace the normal stress in which blood circulates on the left side of the heart. Use all the options.
- A. Aorta
- B. Left ventricle
- C. Pulmonary veins
- D. Left atrium
- E. Mitral valve (correct sequence: 3, 4, 5, 2, 1)
Correct Answer: D
Rationale: Blood flows: pulmonary veins → left atrium → mitral valve → left ventricle → aorta.