Lewis chapter 36

Which of the following information given by a client admitted with chronic stable angina will help the nurse confirm this diagnosis? a. The client rates the pain at a level 3-5 (0-10 scale). b. The client states that the pain "wakes me up at night." c. The client says that the frequency of the pain has increased over the last few weeks. d. The client states that the pain is resolved after taking one sublingual nitroglycerin tablet.

The client states that the pain is resolved after taking one sublingual nitroglycerin tablet.

Which of the following information collected by the nurse who is admitting a client with chest pain suggests that the pain is caused by an acute myocardial infarction? a. The pain increases with deep breathing. b. The pain has persisted longer than 30 minutes. c. The pain worsens when the client raises the arms. d. The pain is relieved after the client takes nitroglycerin

The pain has persisted longer than 30 minutes

To assist the client with coronary artery disease (CAD) in making appropriate dietary changes, which of the following nursing interventions will be most effective? a. Instruct the client that a diet containing no saturated fat and minimal sodium will be necessary. b. Emphasize the increased risk for cardiac problems unless the client makes the dietary changes. c. Assist the client to modify favourite high-fat recipes by using polyunsaturated oils when possible. d. Provide the client with a list of low-sodium, low-cholesterol foods that should be included in the diet.

Assist the client to modify favourite high-fat recipes by using polyunsaturated oils when possible.

Which of the following information is accurate about amlodipine? a. Reduce the "fight or flight" response b. Decrease spasm of the coronary arteries c. Increase the force of myocardial contraction d. Help prevent clotting in the coronary arteries

Decrease spasm of the coronary arteries

. The nurse is developing a health teaching plan for a 60-year-old man with the following risk factors for coronary artery disease (CAD). Which of the following risk factors should the nurse focus on when teaching the client? a. Family history of coronary artery disease b. Increased risk associated with the client's gender c. High incidence of cardiovascular disease in older people d. Elevation of the client's serum low density lipoprotein (LDL) level

Elevation of the client's serum low density lipoprotein (LDL) level

The nurse is caring for a client who has recently started taking rosuvastatin and niacin who reports all of these symptoms to the nurse. Which of the following finding is most important to communicate to the health care provider? a. Generalized muscle aches and weakness b. Skin flushing after taking the medications c. Dizziness when changing positions quickly d. Nausea when taking the drugs before eating

Generalized muscle aches and weakness

The nurse is caring for a client with a non-ST-segment-elevation myocardial infarction (NSTEMI) who is receiving heparin. Which of the following information explains the purpose of the heparin? a. Platelet aggregation is enhanced by IV heparin infusion. b. Heparin will dissolve the clot that is blocking blood flow to the heart. c. Coronary artery plaque size and adherence are decreased with heparin. d. Heparin will prevent the development of new clots in the coronary arteries.

Heparin will prevent the development of new clots in the coronary arteries.

The nurse is caring for a client who has had an acute myocardial infarction and the client asks the nurse about when sexual intercourse can be resumed. Which of the following responses by the nurse is best? a. "Most clients are able to enjoy intercourse without any complications." b. "Sexual activity uses about as much energy as climbing two flights of stairs." c. "The doctor will discuss sexual intercourse when your heart is strong enough." d. "Holding and cuddling are good ways to maintain intimacy after a heart attack."

Sexual activity uses about as much energy as climbing two flights of stairs."

The nurse is admitting a client to the emergency department with severe chest pain and gives the following list of medications taken at home to the nurse. Which of the following medications has the most immediate implications for the client's care? a. Sildenafil b. Furosemide c. Diazepam d. Captopril

Sildenafil

The nurse will suspect that the client with stable angina is experiencing an adverse effect of the prescribed metoprolol if which of the following findings are assessed? a. The client is restless and agitated. b. The blood pressure is 190/110 mm Hg. c. The client complains about feeling anxious. d. The cardiac monitor shows a heart rate of 45.

The cardiac monitor shows a heart rate of 45.

The nurse is providing teaching to a client about use of sublingual nitroglycerin. Which of the following client statements indicates that the teaching has been effective? a. "I can expect indigestion as an adverse effect of nitroglycerin." b. "I can only take the nitroglycerin if I start to have chest pain." c. "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin." d. "I will help slow down the progress of the plaque formation by taking nitroglycerin."

"I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin."

The nurse is providing teaching to a client with chronic stable angina about how to use the prescribed short-acting and long-acting nitrates. Which of the following client statements indicates that the teaching has been effective? a. "I will put on the nitroglycerin patch as soon as I develop any chest pain." b. "I will check the pulse rate in my wrist just before I take any nitroglycerin." c. "I will be sure to remove the nitroglycerin patch before using any sublingual nitroglycerin." d. "I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."

"I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."

The nurse is providing teaching to a client about the use of atenolol in preventing anginal episodes. Which of the following client statements indicate that the teaching has been effective? a. "It is important not to suddenly stop taking the atenolol." b. "Atenolol will increase the strength of my heart muscle." c. "I can expect to feel short of breath when taking atenolol." d. "Atenolol will improve the blood flow to my coronary arteries."

"It is important not to suddenly stop taking the atenolol."

The nurse is caring for a client who is 3 days post myocardial infarction and the client states, "I just had a little chest pain. As soon as I get out of here, I'm going for my vacation as planned." Which of the following responses should the nurse make? a. "Where are you planning to go for your vacation?" b. "What do you think caused your chest pain episode?" c. "Sometimes plans need to change after a heart attack." d. "Recovery from a heart attack takes at least a few weeks."

"What do you think caused your chest pain episode?"

The nurse is administering a fibrinolytic agent to a client with an acute myocardial infarction. Which of the following assessments should cause the nurse to stop the drug infusion? a. Bleeding from the gums b. Surface bleeding from the IV site c. A decrease in level of consciousness d. A nonsustained episode of ventricular tachycardia

A decrease in level of consciousness

The nurse is administering IV nitroglycerin to a client with a myocardial infarction (MI). Which of the following actions should the nurse take to evaluate the effectiveness of the medication? a. Check blood pressure. b. Monitor apical pulse rate. c. Monitor for dysrhythmias. d. Ask about chest discomfort

Ask about chest discomfort