LPN LPN
LPN Pharmacology
1. 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.
2. Why should the client diagnosed with rheumatic heart disease be advised to notify the dentist before dental procedures?
- A. The client requires prophylactic antibiotics before treatment.
- B. The client may experience dysrhythmias with high-speed drills.
- C. The client may have an adverse reaction to lidocaine with epinephrine.
- D. The client may develop heart failure during stressful events.
Correct answer: A
Rationale: Clients with rheumatic heart disease are at risk for infective endocarditis, a serious infection of the heart lining or valves. They need prophylactic antibiotics before invasive procedures, including dental work, to prevent this life-threatening complication. While dysrhythmias with high-speed drills, adverse reactions to local anesthesia, and the risk of heart failure during stressful events are all concerns for clients with heart conditions, the primary reason for notifying the dentist before dental procedures in rheumatic heart disease is the need for prophylactic antibiotics to prevent infective endocarditis.
3. When assisting a hospitalized client newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu, which meal should the nurse encourage the client to select?
- A. Sausage, pancakes, and toast
- B. Broccoli, buttered rice, and grilled chicken
- C. Hamburger, baked apples, and avocado salad
- D. Fresh strawberries, steamed vegetables, and baked fish
Correct answer: D
Rationale: The correct choice is D: Fresh strawberries, steamed vegetables, and baked fish. This meal is low in saturated fats and cholesterol, which is suitable for a client with CAD. It aligns with dietary recommendations to support heart health and manage CAD. Choices A, B, and C are less appropriate as they contain higher levels of saturated fats and cholesterol, which are not ideal for individuals with CAD.
4. The client is being ambulated due to activity intolerance caused by bacterial endocarditis. How can the nurse determine that the client is best tolerating ambulation?
- A. Mild dyspnea after walking 10 feet
- B. Minimal chest pain rated 1 on a 1-to-10 pain scale
- C. Pulse rate that increases from 68 to 94 beats per minute
- D. Blood pressure that increases from 114/82 to 118/86 mm Hg
Correct answer: D
Rationale: A slight increase in blood pressure without significant symptoms indicates that the client is tolerating the activity. In this scenario, a mild increase in blood pressure without other symptoms is a positive sign of tolerance to ambulation despite the underlying condition of bacterial endocarditis. Choices A, B, and C are not the best indicators of tolerance to ambulation in this case. Mild dyspnea after walking a short distance, minimal chest pain, and an increase in pulse rate are common signs that the activity might not be well-tolerated by the client with a history of bacterial endocarditis.
5. A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which sign or symptom that differentiates pericarditis from other cardiopulmonary problems?
- A. Anterior chest pain
- B. Pericardial friction rub
- C. Weakness and irritability
- D. Chest pain that worsens with inspiration
Correct answer: B
Rationale: Pericardial friction rub is a distinctive sign of pericarditis, characterized by a scraping or grating sound heard on auscultation, which helps differentiate pericarditis from other cardiopulmonary conditions. While anterior chest pain may be present in various cardiopulmonary issues, it is not specific to pericarditis. Weakness and irritability are nonspecific symptoms that can be seen in many conditions. Chest pain worsening with inspiration is more indicative of pleuritic conditions such as pleurisy or pneumonia, rather than pericarditis.
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