Nursing Elites

1. A client with a history of angina is scheduled for an exercise electrocardiography (ECG) test. The nurse should explain that the purpose of this test is to evaluate which factor?

• A. The heart's response to physical stress
• B. The client's overall physical fitness
• C. The presence of electrolyte imbalances
• D. The effectiveness of anti-anginal medications

Correct answer: A

Rationale: An exercise electrocardiography (ECG) test is used to evaluate the heart's response to physical stress. During the test, the heart's electrical activity is monitored while the client exercises, helping to identify any areas of ischemia or abnormal rhythms. This test helps healthcare providers assess the heart's function and detect any potential issues related to angina or other cardiac conditions. Choice B, the client's overall physical fitness, is incorrect because the test primarily focuses on the heart's response to stress rather than the client's general physical fitness. Choice C, the presence of electrolyte imbalances, is incorrect as this test is not specifically designed to evaluate electrolyte levels. Choice D, the effectiveness of anti-anginal medications, is incorrect as the main purpose of the test is to assess the heart's response to physical stress, not medication effectiveness.

2. The client with a history of left-sided heart failure is exhibiting increasing shortness of breath and frothy sputum. What is the priority nursing action?

• A. Administer oxygen
• B. Encourage coughing and deep breathing
• C. Place the client in a supine position
• D. Notify the healthcare provider immediately

Correct answer: A

Rationale: Shortness of breath and frothy sputum are indicative of pulmonary edema, a serious condition that requires immediate intervention to improve oxygenation. Administering oxygen is the priority action to support the client's respiratory function and prevent further deterioration. Oxygen therapy helps increase the oxygen levels in the blood, alleviate respiratory distress, and support vital organ function. Prompt intervention with oxygen can help stabilize the client while further assessments and treatments are initiated. Encouraging coughing and deep breathing may worsen the client's condition by increasing respiratory effort. Placing the client in a supine position can further compromise breathing in a client with pulmonary edema. Notifying the healthcare provider is important but not the priority when the client's respiratory status is deteriorating.

3. The nurse is assisting in the care of a client experiencing an acute myocardial infarction (MI). Which medication would the nurse expect to be administered to help reduce myocardial oxygen demand?

• A. Aspirin
• B. Morphine
• C. Atropine
• D. Lidocaine

Correct answer: B

Rationale: In the context of an acute myocardial infarction (MI), morphine is administered to relieve pain and reduce myocardial oxygen demand. By alleviating pain and anxiety, morphine helps reduce oxygen demand on the heart, which is beneficial in the setting of an MI. Aspirin, commonly used for its antiplatelet effects, helps inhibit platelet aggregation and is crucial in the management of MI to prevent further clot formation. Atropine is a medication used to treat symptomatic bradycardia by increasing heart rate, not commonly indicated in the management of acute MI. Lidocaine is used for ventricular dysrhythmias and is not typically given to reduce myocardial oxygen demand in an acute MI scenario.

4. The client is receiving enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Hyperglycemia

Correct answer: B

Rationale: Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, monitoring for hypotension is crucial as it can be a potential adverse effect of this medication. Hypertension, tachycardia, and hyperglycemia are not typically associated with enalapril use. Hypertension is the condition enalapril is used to treat, so it would not be an adverse effect. Tachycardia is not a common adverse effect of enalapril. Enalapril does not typically cause hyperglycemia, as it primarily affects blood pressure regulation.

5. A client with coronary artery disease is prescribed a low-cholesterol diet. The nurse should reinforce which dietary selection made by the client?

• A. Eggs and bacon
• B. Oatmeal with fresh fruit
• C. Cream of chicken soup
• D. Grilled cheese sandwich

Correct answer: B

Rationale: Oatmeal with fresh fruit is a suitable choice for a client with coronary artery disease prescribed a low-cholesterol diet. This option is high in fiber and nutrients, making it a heart-healthy selection. Oatmeal and fresh fruits are low in cholesterol and saturated fats, which helps in managing coronary artery disease. Choices A, C, and D are higher in cholesterol and saturated fats, which can be detrimental for individuals with this condition.

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