NCLEX Review about Cardiac Nursing (41-45)

NCLEX Review about Cardiac Nursing

41. The nurse is completing the admission assessment on the client with chest pain. Which of the following statements by the client indicates the priority modifiable risk factor for coronary artery disease?

a) I have been told that I have a high cholesterol level
b) my father died of a heart attack at age 48
c) I have been under a lot of stress at work lately
d) I know I am overweight and have to do something about it

42. The client with chest pain was diagnosed with myocardial infarction and is now ready to be discharged. The nurse is reviewing discharge instructions. Which statement if made by the client indicates the highest priority teaching need?

a) I am going to try and cut down on smoking
b) from now on I am going to eat mainly fruits and vegetables
c) I plan to take up jogging when I go home
d) I plan to work half days for a while

43. A nurse is providing care to a client immediately after the insertion of a cardiac pacemaker. Which action is most important for the nurse to do first?

a) observe the incision site for signs of local infection
b) arrange for the client to have a post-insertion x-ray
c) monitor vital signs every 15 minutes until stable
d) encourage client to get out of bed with assistance

44. The home care nurse calls the wife of the client with chronic heart disease who is coughing frothy, white secretions and became confused during the night. Which question is most important for the nurse to ask?

a) did your husband eat breakfast this morning?
b) what did your husband do yesterday?
c) where did your husband sleep last night?
d) are your husband's ankles swollen?

45. The nurse is completing the admission assessment form on the client with chronic heart disease. Which of the following, if noted by the nurse, indicates a priority symptom of left-sided heart failure?

a) distended neck vein
b) edema of the lower extremities
c) weight gain of 10 pounds in the last month
d) crackles in the lungs




NCLEX Review about Cardiac Nursing:
ANSWERS AND RATIONALE

41) A

- high serum cholesterol level is one of the most common modifiable risk factor for coronary artery disease.

42) C

- walking is the best exercise for post-MI clients undergoing cardiac rehabilitation. Jogging may not be well-tolerated by the client. Therefore, choice C indicates knowledge deficit of the client and these requires further teaching.

43) C

- close monitoring of the client after insertion of cardiac pacemaker especially the vital signs is very essential. Changes in the vital signs indicate occurrence of complications.

44) C

- orthopnea, like sleeping in a couch indicates progressive heart failure like CHF (congestive heart failure) and pulmonary edema.

45) D

- left-sided congestive heart failure may lead to pulmonary edema. Signs and symptoms pertaining to the lungs are characteristic of left-sided congestive heart failure.
Choices A, B, and C are due to venous back-up which characterize right-sided congestive heart failure.




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