Nursing Elites

1. After returning the client to bed following a cardiac catheterization procedure with the left femoral vessel as the access site, the nurse places a sign above the bed instructing the client to remain on bed rest and in which position?

• A. In semi-Fowler's position
• B. With the head of the bed elevated 45 degrees
• C. With the head of the bed elevated no more than 15 degrees
• D. With the foot of the bed elevated as much as tolerated by the client

Correct answer: C

Rationale: After cardiac catheterization via the femoral vessel, it is crucial to keep the head of the bed elevated no more than 15 degrees to prevent bleeding at the access site. This position helps maintain pressure on the femoral artery, reducing the risk of bleeding and complications post-procedure. Choices A, B, and D are incorrect because they do not provide the necessary pressure on the femoral artery to prevent bleeding, which is essential after a cardiac catheterization procedure with a femoral access site.

2. A client who has been taking prednisone is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

• A. Weight gain
• B. Hyperglycemia
• C. Dry mouth
• D. Increased appetite

Correct answer: B

Rationale: Hyperglycemia is a significant finding in a client taking prednisone as it indicates the medication's impact on glucose metabolism. Prednisone can lead to increased blood sugar levels, which can be detrimental, especially in clients with diabetes or predisposition to hyperglycemia. Reporting hyperglycemia promptly to the healthcare provider is crucial for further evaluation and management to prevent complications. Choices A, C, and D are common side effects of prednisone but are not as concerning as hyperglycemia, which requires immediate attention to avoid potential adverse effects.

3. Which laboratory test should be monitored to evaluate the effectiveness of anticoagulant therapy in a client with deep vein thrombosis (DVT)?

• A. Complete blood count (CBC)
• B. Activated partial thromboplastin time (aPTT)
• C. Serum electrolytes
• D. Liver function tests

Correct answer: B

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory test monitored to evaluate the effectiveness of anticoagulant therapy, particularly with heparin. It measures the time it takes for blood to clot, and monitoring aPTT helps ensure the therapeutic range is maintained to prevent clot formation and excessive bleeding. Choices A, C, and D are incorrect because a complete blood count (CBC) assesses overall health, serum electrolytes evaluate the body's electrolyte balance, and liver function tests assess liver health, none of which directly evaluate the effectiveness of anticoagulant therapy for DVT.

4. A client's serum calcium level is 7.9 mg/dL. The nurse is immediately concerned, knowing that this level could lead to which complication?

• A. Stroke
• B. Cardiac arrest
• C. High blood pressure
• D. Urinary stone formation

Correct answer: B

Rationale: A serum calcium level below normal (hypocalcemia) can lead to cardiac arrhythmias and potentially cardiac arrest. Calcium plays a crucial role in cardiac muscle contractility, and low levels can disrupt normal heart function, potentially leading to fatal arrhythmias and cardiac arrest. Choices A, C, and D are incorrect as hypocalcemia is not directly associated with stroke, high blood pressure, or urinary stone formation. The immediate concern with low serum calcium levels is the risk of cardiac complications.

5. The healthcare provider has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

• A. I should substitute eggs and milk for meat.
• B. I will eliminate all cholesterol and fat from my diet.
• C. I should routinely use polyunsaturated oils in my diet.
• D. I need to consider becoming a strict vegetarian.

Correct answer: C

Rationale: The correct answer is C. Using polyunsaturated oils, such as vegetable oils, can help manage cholesterol levels and reduce the risk of heart disease. This dietary change is beneficial for individuals with coronary artery disease as it promotes heart health by improving cholesterol profiles. Substituting eggs and milk for meat (Choice A) may not address the overall dietary needs for managing the condition. Completely eliminating all cholesterol and fat from the diet (Choice B) is not necessary as the body needs some healthy fats. Considering becoming a strict vegetarian (Choice D) is a personal choice and may not necessarily be required to manage coronary artery disease.

Similar Questions