Nursing Elites

1. The nurse is caring for a client who has returned to the unit after undergoing a cardiac catheterization. The nurse should monitor for which common complication following this procedure?

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

Correct answer: C

Rationale: Following a cardiac catheterization, a common complication to monitor for is bleeding or hemorrhage at the catheter insertion site. Hemorrhage is a significant concern due to the potential for rapid blood loss, leading to hypovolemic shock and other serious complications. Monitoring for signs of bleeding, such as swelling, hematoma, or drop in hemoglobin levels, is crucial for timely intervention. Hypertension is not a common complication post-cardiac catheterization; instead, hypotension may occur due to vasovagal response or bleeding. Hyperglycemia is not typically associated with cardiac catheterization unless the client has pre-existing diabetes or stress-induced hyperglycemia.

2. A healthcare provider is providing discharge instructions to a client who has a new prescription for digoxin. Which of the following instructions should the healthcare provider include?

• A. Take the medication at bedtime.
• B. Avoid taking antacids with this medication.
• C. Monitor your pulse rate daily.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is C: 'Monitor your pulse rate daily.' Monitoring the pulse rate daily is crucial when taking digoxin as it helps in early detection of digoxin toxicity. Digoxin can cause toxicity, which may manifest as changes in the heart rate, making monitoring the pulse rate an essential part of managing the medication. It is important for the client to be aware of their normal pulse rate and report any significant changes to their healthcare provider promptly. Choices A, B, and D are incorrect. Taking digoxin at bedtime is not a specific instruction related to monitoring its effects. Avoiding antacids is relevant for some medications, but not a key concern with digoxin. Increasing potassium-rich foods may interact with digoxin due to its effect on potassium levels, but monitoring the pulse rate is a more direct and immediate need for safety.

3. A healthcare professional is assessing a client who has been taking furosemide. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Increased appetite

Correct answer: C

Rationale: Hypokalemia is a known side effect of furosemide, a loop diuretic. Furosemide causes increased excretion of potassium in the urine, leading to low potassium levels in the body which can result in serious complications such as cardiac dysrhythmias. Therefore, any signs or symptoms of hypokalemia should be promptly reported to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because weight gain, dry cough, and increased appetite are not typically associated with furosemide use and are not concerning side effects that require immediate reporting to the provider.

4. A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action?

• A. Assist the client to get back into bed.
• B. Report the chest pain episode to the healthcare provider.
• C. Tell the client to stand still and take the client's blood pressure.
• D. Give a nitroglycerin (Nitrostat) tablet and assist the client to the bathroom.

Correct answer: A

Rationale: In a client with myocardial infarction experiencing chest pain during activity, the priority action is to stop the activity immediately to reduce the heart's workload and oxygen demand. Assisting the client back to bed helps in reducing stress on the heart and can prevent worsening of the condition. Reporting the chest pain episode to the healthcare provider is important but should not delay taking immediate action to alleviate symptoms. Taking the client's blood pressure and administering nitroglycerin are secondary actions after ensuring the client's safety and comfort. Therefore, the correct action is to assist the client back into bed.

5. While preparing a client for a cardiac catheterization, the client expresses a preference to speak with their doctor rather than the nurse. Which response by the nurse should be therapeutic?

• A. Your doctor expects me to prepare you for this procedure.
• B. That's fine, if that's what you want. I'll call your health care provider.
• C. So you're saying that you want to talk to your health care provider?
• D. I'm concerned with the way you've dismissed me. I know what I am doing.

Correct answer: C

Rationale: The therapeutic response by the nurse in this situation involves reflecting the client's feelings back to them, which demonstrates active listening and empathy. By restating the client's preference to talk to their doctor, the nurse acknowledges and validates the client's feelings, thereby fostering a positive therapeutic relationship and promoting open communication. Choices A and B do not acknowledge the client's preference and may come off as dismissive. Choice D is confrontational and defensive, which can lead to a breakdown in communication and trust between the nurse and the client.

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