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A nurse is caring for a client who enters the emergency department complaining of severe chest
pain. Which of the following interven ons should the nurse implement to determine if the
client is experiencing a myocardial infarc on?
A. Check the client's blood pressure.
B. Auscultate heart tones.
C. Perform a 12-lead ECG.
D. Determine if pain radiates to the le( arm. - C. Perform a 12-lead ECG.
Beta adrenergic blockers cause?
A. Tachycardia
B. Bradycardia
C. Hypertension
D. Tachypnea - B. Bradycardia
A nurse is contribu ng to the plan of care for an older adult client who is at risk for
osteoporosis. Which of the following interven ons should the nurse include to prevent bone
loss? - Encourage weight-bearing exercises
A nurse is reinforcing discharge teaching to prevent dumping syndrome for a client following a
par al gastrectomy for ulcers. Which of the following informa on should the nurse include in
the teaching? - Avoid liquids at meal mes
, A nurse is collec ng data on a client who is scheduled for a cardiac catheteriza on. Which of
the following laboratory levels should review prior to the procedure? - BUN
A nurse is caring for a client who is at risk for developing pressure ulcers. Which of the
following ac ons should the nurse take? - Posi on pillows between the bony prominences.
A nurse is caring for a client who has meningococcal pneumonia. Which of the following
personal protec ve equipment should the nurse use? - Mask
A nurse is caring for a client following cardiac catheteriza on. Which of the following is an
appropriate nursing ac on?
a. Monitor pedal pulses every 15 min.
b. Perform passive range of mo on to the affected extremity.
c. Ambulate the client when he is awake and alert.
d. Keep the client in high-Fowler's posi on for 6 hr. - a. Monitor pedal pulses every 15 min.
a nurse is collect data from a client who has right sided heart failure. which of the following
findings should the nurse expect?
a. frothy sputum
b. dyspnea.
c. orthopnea
d. peripheral edema - d. peripheral edema
A nurse is collec ng data from a client who has an acute myocardial infarc on (MI). Which of
the following clinical manifesta ons should the nurse expect to find? (Select all that apply.)
a. Orthopnea
b. Headache
, c. Nausea
d. Tachycardia
e. Diaphoresis - Nausea
Tachycardia
Diaphoresis
A client asks a nurse, "Why am I taking nitroglycerin?" Which of the following is the best
response by the nurse?
a. "Nitroglycerin relieves nausea and prevents vomi ng which could lead to aspira on."
b. "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries."
c. "Nitroglycerin acts as a bronchodilator to open small airways and decrease shortness of
breath."
d. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart." -
"Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
A client comes to the emergency department via ambulance to report severe radia ng chest
pain and shortness of breath. The client appears restless, frightened, and slightly cyano c. The
provider prescribes oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and
a 12-lead ECG. Which of the following ac ons should the nurse assis ng with this client's care
take first?
a. ABach the leads for a 12-lead ECG.
b. Obtain the blood sample.
c. Ini ate oxygen therapy.