Nursing Elites

1. The healthcare professional is collecting data on a client who was just admitted to the hospital with a diagnosis of coronary artery disease (CAD). The client reveals having been under a great deal of stress recently. What should the healthcare professional do next?

• A. Ask whether the client wants to seek counseling or therapy.
• B. Explore with the client the sources of stress in their life.
• C. Reassure the client that stress is common in today's world.
• D. Ask the client to make a list of stressors for later evaluation.

Correct answer: B

Rationale: It is important for the healthcare professional to explore the sources of stress with the client to develop an effective stress management plan tailored to the individual's specific stressors. By understanding the sources of stress, healthcare professionals can identify triggers, implement appropriate interventions, and support the client's overall well-being. Option A is not the immediate next step as exploring the sources of stress should come before suggesting counseling or therapy. Option C is dismissive of the client's feelings and does not address the need for personalized stress management. Option D delays the process by asking the client to make a list without actively engaging in a discussion to identify stressors.

2. A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. What action should the nurse take?

• A. Obtain a prescription for pain medication.
• B. Have the client stop and lie back down in bed.
• C. Report the complaint to the healthcare provider.
• D. Instruct the client to continue getting out of bed and into a chair.

Correct answer: B

Rationale: When a client with CAD experiences chest pain, it indicates myocardial ischemia. The nurse should have the client stop the activity and lie back down in bed to reduce the heart's oxygen demand, decrease myocardial workload, and prevent further ischemia. This action helps in improving blood flow to the heart and can potentially alleviate the chest pain. Option A is incorrect as pain medication should not be the initial action for chest pain in CAD. Option C is incorrect because the nurse should first intervene directly to address the chest pain. Option D is incorrect as continuing the activity can worsen the myocardial ischemia and chest pain.

3. A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory value should the nurse monitor to assess the effectiveness of the medication?

• A. Activated partial thromboplastin time (aPTT)
• B. Prothrombin time (PT) and international normalized ratio (INR)
• C. Platelet count
• D. Erythrocyte sedimentation rate (ESR)

Correct answer: B

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are the laboratory values used to monitor the effectiveness of warfarin therapy. These values help ensure that the client is within the therapeutic range for anticoagulation. PT measures the time it takes for blood to clot, while INR standardizes PT results to minimize variations between laboratories. Monitoring these values is crucial to prevent complications such as bleeding or clot formation. Activated partial thromboplastin time (aPTT) (Choice A) is more commonly used to monitor heparin therapy. Platelet count (Choice C) assesses the number of platelets in the blood and is not specific to warfarin therapy. Erythrocyte sedimentation rate (ESR) (Choice D) is a non-specific marker of inflammation and is not used to monitor the effectiveness of warfarin therapy.

4. A client with atrial fibrillation is receiving warfarin (Coumadin). The nurse should monitor which laboratory test to determine the effectiveness of the therapy?

• A. Prothrombin time (PT) and international normalized ratio (INR)
• B. Activated partial thromboplastin time (aPTT)
• C. Complete blood count (CBC)
• D. Fibrinogen level

Correct answer: A

Rationale: To monitor the effectiveness of warfarin therapy in a client with atrial fibrillation, the nurse should assess the Prothrombin time (PT) and international normalized ratio (INR) levels. These tests help determine the clotting ability of the blood and ensure that the client's anticoagulation levels are within the therapeutic range, reducing the risk of bleeding or clotting complications. Activated partial thromboplastin time (aPTT) (Choice B) is more commonly used to monitor heparin therapy. Complete blood count (CBC) (Choice C) provides information about the cellular components of blood but does not directly assess the effectiveness of warfarin therapy. Fibrinogen level (Choice D) is not typically used to monitor warfarin therapy; it reflects the level of fibrinogen in the blood, which is involved in the clotting process.

5. The nurse is reinforcing instructions to a client with coronary artery disease who is prescribed a low-cholesterol diet. The nurse should advise the client to choose which food item?

• 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 on a low-cholesterol diet as it is low in cholesterol and provides heart-healthy benefits. Eggs and bacon, cream of chicken soup, and grilled cheese sandwich are higher in cholesterol and may not be as heart-healthy for this client. Eggs and bacon are high in cholesterol, cream of chicken soup may contain saturated fats, and a grilled cheese sandwich typically contains high amounts of fat and cholesterol, making them less suitable choices for a client with coronary artery disease on a low-cholesterol diet.

Similar Questions