the nurse is performing discharge teaching for mrs s after cardiac angioplasty her husband is present for the teaching while explaining the prescripti

NCLEX-RN

Saunders NCLEX RN Practice Questions

1. The nurse is performing discharge teaching for Mrs. S after cardiac angioplasty. Her husband is present for the teaching. While explaining the prescription for antiplatelet medication to use at home, Mrs. S's husband states, 'I don't think I can afford to refill that medication.' What is the most appropriate response of the nurse?

A. Don't worry, your insurance will cover it.
B. I'll ask the physician if he can prescribe a medication that is more affordable.
C. You should apply for Medicare to see if they can help you.
D. This medication is essential for her care and should be given priority over all others that she is taking.

Correct answer: B

Rationale: The most appropriate response for the nurse in this situation is to offer assistance in exploring more affordable medication options. It is important to address the patient's concerns about medication costs to ensure adherence to the treatment plan. By suggesting to ask the physician if a more affordable alternative is available, the nurse shows understanding and a commitment to helping the patient access necessary medications. Choice A is incorrect because assuming insurance coverage without verifying can lead to false expectations. Choice C is incorrect as Medicare eligibility and assistance may not be applicable in this scenario. Choice D is incorrect as it does not address the financial concern raised by the husband and emphasizes the importance of the medication without offering a practical solution to affordability.

2. The client is receiving discharge teaching seven (7) days post myocardial infarction and inquires why he must wait six (6) weeks before engaging in sexual intercourse. What is the best response by the nurse to this question?

A. "You need to regain your strength before attempting such exertion."?
B. "When you can climb 2 flights of stairs without problems, it is generally safe."?
C. "Have a glass of wine to relax you, then you can try to have sex."?
D. "If you can maintain an active walking program, you will have less risk."?

Correct answer: B

Rationale: Following a myocardial infarction, there is a risk of cardiac rupture at the site of the infarction for approximately six (6) weeks until scar tissue forms. The advice to wait until the client can climb two flights of stairs without issues is common among healthcare providers as it indicates an adequate level of physical exertion tolerance and suggests a lower risk of complications during sexual activity. Choice A is not specific to the recovery timeline related to sexual activity post-myocardial infarction. Choice C is inappropriate as alcohol consumption should not be recommended before sexual activity. Choice D, though promoting an active lifestyle, does not directly address the safety concerns related to sexual intercourse post-myocardial infarction.

3. What ethical principle has led to the need for informed consent?

A. Autonomy
B. Justice
C. Fidelity
D. Beneficence

Correct answer: A

Rationale: Autonomy is the ethical principle that emphasizes an individual's right to make their own decisions if they are mentally competent. Informed consent is a direct result of this principle, as it ensures that patients are fully informed before agreeing to any medical intervention. Autonomy is crucial in healthcare as it respects patients' rights and promotes self-determination. Justice, fidelity, and beneficence are important ethical principles in healthcare, but they do not directly lead to the need for informed consent. Justice focuses on fairness and equal treatment, fidelity on trustworthiness and loyalty, and beneficence on doing good for the patient's benefit.

4. A client has volunteered to take part in a research study. After participating for two months, he decides that he can no longer tolerate the study and decides to leave. What are the client's rights in this situation?

A. The client has a right to be released from the study but must reimburse the researchers for charges incurred
B. The client has a right to be released from the study without any liability
C. The client has a right to be released from the study but is prohibited from participating in any future studies
D. The client does not have the right to be released from the study; he must finish his participation

Correct answer: B

Rationale: When a client voluntarily participates in a research study and later decides to withdraw, they have the right to be released from the study without any liability. It is unethical to force a participant to continue in a study against their will as this violates their autonomy and personal rights. Choice A is incorrect as it suggests that the client must reimburse the researchers for charges incurred, which is not typically the case unless agreed upon beforehand. Choice C is incorrect as there is no standard practice prohibiting a participant from future studies just because they withdrew from a current one. Choice D is incorrect because participants always have the right to withdraw from a research study at any time.

5. A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?

A. Family history of heart disease
B. Overweight
C. Smoking
D. Age

Correct answer: A

Rationale: A family history of heart disease is an inherited risk factor for developing atherosclerosis. This factor is not modifiable through lifestyle changes. Studies have shown that having a first-degree relative with heart disease significantly increases the individual's risk of developing atherosclerosis. Overweight, smoking, and age are not hereditary risk factors for atherosclerosis. Overweight and smoking are lifestyle-related risk factors, while age is a non-modifiable risk factor that increases with time but is not directly inherited.