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NSG 430 Exam 2 – Community Health
Nursing Review Part B.
A PATIENT SEEKS CARE IN THE EMERGENCY DEPARTMENT AFTER SHARING NEEDLES FOR
HEROIN INJECTION
WITH A FRIEND WHO HAS HEPATITIS B. TO PROVIDE IMMEDIATE PROTECTION FROM
INFECTION, WHAT
MEDICATION WILL THE NURSE EXPECT TO ADMINISTER?
A. CORTICOSTEROIDS
B. GAMMA GLOBULIN
C. HEPATITIS B VACCINE
D. FRESH FROZEN PLASMA
GAMMA GLOBULIN
THE PATIENT WOULD FIRST RECEIVE ANTIBODIES FOR HEPATITIS B FROM INJECTION OF
GAMMA GLOBULIN.
THE HEPATITIS B VACCINATION SERIES WOULD BE STARTED TO PROVIDE ACTIVE
IMMUNITY. FRESH FROZEN
PLASMA AND CORTICOSTEROIDS WILL NOT BE EFFECTIVE IN PREVENTING HEPATITIS B IN
THE PATIENT.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
THE NURSE TEACHES A PATIENT ABOUT DRUG THERAPY AFTER A KIDNEY TRANSPLANT.
WHICH STATEMENT BY
THE PATIENT INDICATES A NEED FOR FURTHER INSTRUCTIONS?
A. ―I NEED TO BE MON ITORED CLOSELY FOR DEVELOPMENT OF CANCER .‖
B. ―AFTER A COUPLE O F YEARS, I WILL BE ABLE TO STOP TAKING
IMMUNOSUPPRESSANTS.‖
C. ―IF I DEVELOP AN ACUTE REJECTION EPISODE, I WILL NEED ADDITIONAL TYPES OF
DRUGS.‖
D. ―THE DRUGS ARE CO MBINED TO INHIBIT DIFFERENT WAYS THE KIDNEY CAN BE
REJECTED.‖
―AFTER A COUPLE OF Y EARS, I WILL BE ABLE TO STOP TAKING IMMUN OSUPPRESSANTS.‖
IMMUNOSUPPRESSANTS WILL NEED TO BE CONTINUED FOR LIFE. THE OTHER PATIENT
STATEMENTS ARE
ACCURATE AND INDICATE THAT NO FURTHER TEACHING IS NECESSARY ABOUT THOSE
TOPICS.
AN OLDER ADULT PATIENT HAS A PRESCRIPTION FOR CYCLOSPORINE FOLLOWING A
KIDNEY TRANSPLANT.
WHICH INFORMATION IN THE PATIENT'S HEALTH HISTORY HAS IMPLICATIONS FOR
PLANNING PATIENT
TEACHING ABOUT THE SAFE USE OF CYCLOSPORINE?
A. THE PATIENT RESTRICTS SALT TO 2 GRAMS PER DAY.
B. THE PATIENT EATS GREEN LEAFY VEGETABLES DAILY.
C. THE PATIENT DRINKS GRAPEFRUIT JUICE EVERY DAY.
D. THE PATIENT DRINKS 3 TO 4 QUARTS OF FLUID EACH DAY.
THE PATIENT DRINKS GRAPEFRUIT JUICE EVERY DAY.
GRAPEFRUIT JUICE CAN INCREASE THE TOXICITY OF CYCLOSPORINE. THE PATIENT SHOULD
BE TAUGHT TO
AVOID GRAPEFRUIT JUICE. NORMAL FLUID AND SODIUM INTAKE OR EATING GREEN LEAFY
VEGETABLES WILL
NOT AFFECT CYCLOSPORINE LEVELS OR RENAL FUNCTION.
PATIENT IS ADMITTED TO THE HOSPITAL WITH ACUTE REJECTION OF A KIDNEY
TRANSPLANT. WHICH
INTERVENTION WOULD THE NURSE EXPECT FOR THIS PATIENT?
A. TESTING FOR HUMAN LEUKOCYTE ANTIGEN (HLA) MATCH
A PATIENT IN THE HEALTH CARE PROVIDER'S OFFICE FOR ALLERGEN TESTING USING THE
CUTANEOUS SCRATCH
METHOD DEVELOPS ITCHING AND SWELLING AT THE SKIN SITE. WHICH ACTION WOULD
THE NURSE PLAN TO
TAKE FIRST?
A. MONITOR THE PATIENT'S EDEMA.
B. ADMINISTER A DOSE OF EPINEPHRINE.
C. OBTAIN A PRESCRIPTION FOR ORAL ANTIHISTAMINES.
D. ASSESS THE PATIENT'S USE OF NEW SKIN PRODUCTS
ADMINISTER A DOSE OF EPINEPHRINE
RAPID ADMINISTRATION OF EPINEPHRINE WHEN EXCESSIVE ITCHING OR SWELLING AT
THE SKIN SITE IS
OBSERVED CAN PREVENT THE PROGRESSION TO ANAPHYLAXIS. THE INITIAL SYMPTOMS
OF ANAPHYLAXIS ARE
ITCHING AND EDEMA AT THE SITE OF THE EXPOSURE. THE NURSE SHOULD NOT WAIT AND
ASSESS FOR
DEVELOPMENT OF MORE EDEMA. HYPOTENSION, TACHYCARDIA, DILATED PUPILS, AND
WHEEZES OCCUR
LATER. EXPOSURE TO SKIN PRODUCTS DOES NOT ADDRESS THE IMMEDIATE CONCERN OF
A POSSIBLE
ANAPHYLACTIC REACTION.
A PATIENT IN THE EMERGENCY ROOM IS ANXIOUS AND REPORTS DIFFICULTY BREATHING
AFTER BEING STUNG
BY A WASP. WHICH ACTION WOULD THE NURSE TAKE FIRST?
A. PROVIDE HIGH-FLOW OXYGEN.
B. ADMINISTER ANTIHISTAMINES.
C. ASSESS THE PATIENT'S AIRWAY.
D. REMOVE THE STINGER FROM THE SITE.
ASSESS THE PATIENT'S AIRWAY.
THE INITIAL ACTION WITH ANY PATIENT WITH DIFFICULTY BREATHING IS TO ASSESS AND
MAINTAIN THE
AIRWAY. THE PATIENT'S SYMPTOMS OF ANXIETY AND DIFFICULTY BREATHING MAY HAVE
OTHER CAUSES
THAN ANAPHYLAXIS, SO ADDITIONAL ASSESSMENT IS WARRANTED. THE OTHER ACTIONS
ARE PART OF THE
EMERGENCY MANAGEMENT PROTOCOL FOR ANAPHYLAXIS, BUT THE PRIORITY IS AIRWAY
ASSESSMENT AND
MAINTENANCE.
IMMEDIATELY AFTER THE NURSE ADMINISTERS AN INTRADERMAL INJECTION OF AN
ALLERGEN ON THE FOREARM,
THE PATIENT REPORTS ITCHING AT THE SITE, WEAKNESS, AND DIZZINESS. WHICH ACTION
WOULD THE NURSE
TAKE FIRST?
A. APPLY ANTIINFLAMMATORY CREAM.
B. PLACE A TOURNIQUET ABOVE THE SITE.
C. ADMINISTER SUBCUTANEOUS EPINEPHRINE.
D. RESCHEDULE THE PATIENT'S OTHER ALLERGEN TESTS.
PLACE A TOURNIQUET ABOVE THE SITE.
APPLICATION OF A TOURNIQUET WILL DECREASE SYSTEMIC CIRCULATION OF THE
ALLERGEN AND SHOULD BE
THE FIRST REACTION. THE OTHER ACTIONS MAY OCCUR, BUT THE TOURNIQUET
APPLICATION SLOWS THE
ALLERGEN PROGRESS INTO THE PATIENT'S SYSTEM, ALLOWING TREATMENT OF THE
ANAPHYLACTIC RESPONSE. A
LOCAL ANTIINFLAMMATORY CREAM MAY BE APPLIED TO THE SITE OF A CUTANEOUS TEST
FOR PERSISTENT
ANGIOEDEMA IS CHARACTERIZED BY SWELLING OF THE EYELIDS, LIPS, AND TONGUE.
WHEAL AND FLARE
LESIONS, CLEAR NASAL DRAINAGE, AND HYPOTENSION AND TACHYCARDIA ARE
CHARACTERISTIC OF OTHER
ALLERGIC REACTIONS
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
A NURSE HAS OBTAINED DONOR TISSUE TYPING INFORMATION ABOUT A PATIENT WHO
IS WAITING FOR A
KIDNEY TRANSPLANT. WHICH RESULT SHOULD THE NURSE REPORT TO THE TRANSPLANT
SURGEON?
A. THE PATIENT-DONOR CROSSMATCH IS POSITIVE.
B. SIX ANTIGEN MATCHES ARE PRESENT IN HLA TYPING.
C. THE PATIENT IS RH POSITIVE AND DONOR IS RH NEGATIVE.
D. PANEL OF REACTIVE ANTIBODIES (PRA) PERCENTAGE IS LOW.
THE PATIENT-DONOR CROSSMATCH IS POSITIVE.
POSITIVE CROSS MATCHING IS AN ABSOLUTE CONTRAINDICATION TO KIDNEY
TRANSPLANTATION BECAUSE A
HYPERACUTE REJECTION WILL OCCUR AFTER THE TRANSPLANT. THE OTHER
INFORMATION SHOWS THAT THE
TISSUE MATCH BETWEEN THE PATIENT AND POTENTIAL DONOR IS ACCEPTABLE.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
A PATIENT WHO IS RECEIVING IMMUNOTHERAPY HAS JUST RECEIVED AN ALLERGEN
INJECTION. WHICH
FINDING IS MOST IMPORTANT TO COMMUNICATE TO THE HEALTH CARE PROVIDER?
A. THE PATIENT'S IGG LEVEL IS INCREASED.
B. THERE IS REDNESS AND SWELLING AT THE INJECTION SITE.
C. THERE IS A 2-CM WHEAL AT THE SITE OF THE INJECTION.
D. THE PATIENT'S SYMPTOMS DID NOT IMPROVE IN 2 MONTHS.
THERE IS A 2-CM WHEAL AT THE SITE OF THE INJECTION.
A LOCAL REACTION LARGER THAN QUARTER SIZE MAY INDICATE THAT A DECREASE IN THE
ALLERGEN DOSE IS
NEEDED. AN INCREASE IN IGG SHOWS THAT THE THERAPY IS EFFECTIVE. REDNESS AND
SWELLING AT THE
SITE ARE NOT UNUSUAL. BECAUSE IMMUNOTHERAPY USUALLY TAKES 1 TO 2 YEARS TO
ACHIEVE AN EFFECT,
AN IMPROVEMENT IN THE PATIENT'S SYMPTOMS IS NOT EXPECTED AFTER A FEW
MONTHS.
THE NURSE IS ADMITTING A PATIENT WITH POSSIBLE RHEUMATIC FEVER. WHICH
QUESTION ON THE
ADMISSION HEALTH HISTORY FOCUSES ON A PERTINENT RISK FACTOR FOR RHEUMATIC
FEVER?
A. ―DO YOU USE ANY ILLEGAL IV DRUGS?‖
B. ―HAVE YOU EVER INJURED YOUR CHEST?‖
C. ―HAVE YOU HAD A RECENT SORE TH ROAT?‖
D. ―DO YOU HAVE A FA MILY HISTORY OF HEAR T DISEASE?‖
―HAVE YOU HAD A RECENT SORE THROAT?‖
RHEUMATIC FEVER OCCURS BECAUSE OF AN ABNORMAL IMMUNE RESPONSE TO A
STREPTOCOCCAL INFECTION.
ALTHOUGH IV DRUG USE SHOULD BE DISCUSSED WITH THE PATIENT BEFORE DISCHARGE,
IT IS NOT A RISK
FACTOR FOR RHEUMATIC FEVER. FAMILY HISTORY IS NOT A RISK FACTOR FOR
RHEUMATIC FEVER. CHEST INJURY
WOULD CAUSE MUSCULOSKELETAL CHEST PAIN RATHER THAN RHEUMATIC FEVER.
―I WILL BE IMMUNE TO FUTURE EPISODES OF RHEUMATIC FEVER AFTER THIS
INFECTION.‖
PATIENTS WITH A HISTORY OF RHEUMATIC FEVER ARE MORE SUSCEPTIBLE TO A SECOND
EPISODE. PATIENTS
WITH RHEUMATIC FEVER WITHOUT CARDITIS REQUIRE PROPHYLAXIS UNTIL AGE 20 YEARS
AND FOR A
MINIMUM OF 5 YEARS. THE OTHER PATIENT STATEMENTS ARE CORRECT.
WHICH ACTION WOULD THE NURSE INCLUDE IN A COMMUNITY HEALTH PROGRAM TO
DECREASE THE
INCIDENCE OF RHEUMATIC FEVER?
A. VACCINATE HIGH-RISK GROUPS IN THE COMMUNITY WITH STREPTOCOCCAL VACCINE.
B. TEACH COMMUNITY MEMBERS TO SEEK TREATMENT FOR STREPTOCOCCAL
PHARYNGITIS.
C. TEACH ABOUT THE IMPORTANCE OF MONITORING TEMPERATURE WHEN SORE
THROATS OCCUR.
D. TEACH ABOUT PROPHYLACTIC ANTIBIOTICS TO THOSE WITH A FAMILY HISTORY OF
RHEUMATIC
FEVER.
TEACH COMMUNITY MEMBERS TO SEEK TREATMENT FOR STREPTOCOCCAL PHARYNGITIS.
THE INCIDENCE OF RHEUMATIC FEVER IS DECREASED BY TREATMENT OF STREPTOCOCCAL
INFECTIONS WITH
ANTIBIOTICS. FAMILY HISTORY IS NOT A RISK FACTOR FOR RHEUMATIC FEVER. THERE IS
NO IMMUNIZATION
THAT IS EFFECTIVE IN DECREASING THE INCIDENCE OF RHEUMATIC FEVER. TEACHING
ABOUT MONITORING
TEMPERATURE WILL NOT DECREASE THE INCIDENCE OF RHEUMATIC FEVER.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
WHICH FINDING FOR A PATIENT WITH MITRAL VALVE STENOSIS WOULD BE OF MOST
CONCERN TO THE NURSE?
A. DIASTOLIC MURMUR
B. PERIPHERAL EDEMA
C. SHORTNESS OF BREATH ON EXERTION
D. RIGHT UPPER QUADRANT TENDERNESS
SHORTNESS OF BREATH ON EXERTION
THE PRESSURE GRADIENT CHANGES IN MITRAL STENOSIS LEAD TO FLUID BACKUP INTO
THE LUNGS, RESULTING
IN HYPOXEMIA AND DYSPNEA. THE OTHER FINDINGS ALSO MAY BE ASSOCIATED WITH
MITRAL VALVE
DISEASE BUT ARE NOT INDICATORS OF HYPOXEMIA, WHICH IS A PRIORITY.
A 21-YR-OLD WOMAN IS CONSIDERING HEART VALVE REPLACEMENT SURGERY. WHICH
INFORMATION WOULD
THE NURSE INCLUDE WHEN EXPLAINING THE DIFFERENCES IN ONGOING CARE REQUIRED
WITH DIFFERENT
TYPES OF VALVES?
A. BIOLOGIC VALVES REQUIRE IMMUNOSUPPRESSIVE DRUGS AFTER SURGERY.
B. MECHANICAL MITRAL VALVES NEED TO BE REPLACED SOONER THAN BIOLOGIC VALVES.
C. LIFELONG ANTICOAGULANT THERAPY IS NEEDED AFTER MECHANICAL VALVE
REPLACEMENT.
D. ONGOING CARE BY A HEALTH CARE PROVIDER IS NOT NECESSARY AFTER VALVE
REPLACEMENT.
LIFELONG ANTICOAGULANT THERAPY IS NEEDED AFTER MECHANICAL VALVE
REPLACEMENT.
LONG-TERM ANTICOAGULATION THERAPY IS NEEDED AFTER MECHANICAL VALVE
REPLACEMENT, AND THIS
WOULD RESTRICT DECISIONS ABOUT CAREER AND CHILDBEARING IN THIS PATIENT.
MECHANICAL VALVES ARE
C. TEACH THE PATIENT TO USE SUBLINGUAL NITROGLYCERIN FOR CHEST PAIN.
D. RAISE THE HEAD OF THE BED 60 DEGREES TO DECREASE VENOUS RETURN.
PROMOTE REST TO DECREASE MYOCARDIAL OXYGEN DEMAND.
REST IS RECOMMENDED TO BALANCE MYOCARDIAL OXYGEN SUPPLY AND DEMAND AND
TO DECREASE CHEST
PAIN. THE PATIENT WITH AORTIC STENOSIS REQUIRES HIGHER PRELOAD TO MAINTAIN
CARDIAC OUTPUT, SO
NITROGLYCERIN AND MEASURES TO DECREASE VENOUS RETURN ARE CONTRAINDICATED.
ANTICOAGULATION IS
NOT RECOMMENDED UNLESS THE PATIENT HAS ATRIAL FIBRILLATION.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
AN OLDER ADULT PATIENT WHO HAD A MITRAL VALVE REPLACEMENT WITH A
MECHANICAL VALVE IS TAKING
WARFARIN. WHICH INFORMATION WOULD THE NURSE INCLUDE IN DISCHARGE
TEACHING?
A. USE OF DAILY ASPIRIN FOR ANTICOAGULATION.
B. CORRECT METHOD FOR TAKING THE RADIAL PULSE.
C. NEED FOR FREQUENT LABORATORY BLOOD TESTING.
D. PLAN TO AVOID ANY PHYSICAL ACTIVITY FOR 1 MONTH.
NEED FOR FREQUENT LABORATORY BLOOD TESTING
ANTICOAGULATION WITH WARFARIN (COUMADIN) IS NEEDED FOR A PATIENT WITH
MECHANICAL VALVES TO
PREVENT CLOTTING ON THE VALVE. THIS WILL REQUIRE FREQUENT INTERNATIONAL
NORMALIZED RATIO TESTING.
DAILY ASPIRIN USE WILL NOT BE EFFECTIVE IN REDUCING THE RISK FOR CLOTS ON THE
VALVE. MONITORING
OF THE RADIAL PULSE IS NOT NECESSARY AFTER VALVE REPLACEMENT. PATIENTS SHOULD
RESUME ACTIVITIES
OF DAILY LIVING AS TOLERATED.
A PATIENT RECOVERING FROM HEART SURGERY DEVELOPS PERICARDITIS AND REPORTS
LEVEL 6 (0 TO 10
SCALE) CHEST PAIN WITH DEEP BREATHING. WHICH PRESCRIBED PRN MEDICATION WILL
LIKELY BE THE
MOST HELPFUL IN RELIEVING THE PAIN?
A. FENTANYL 1 MG IV
B. IV MORPHINE SULFATE 4 MG
C. ORAL IBUPROFEN (MOTRIN) 600 MG
D. ORAL ACETAMINOPHEN (TYLENOL) 650 MG
ORAL IBUPROFEN (MOTRIN) 600 MG
THE PAIN ASSOCIATED WITH PERICARDITIS IS CAUSED BY INFLAMMATION, SO
NONSTEROIDAL
ANTIINFLAMMATORY DRUGS (E.G., IBUPROFEN) ARE MOST EFFECTIVE. OPIOID
ANALGESICS AND
ACETAMINOPHEN ARE NOT VERY EFFECTIVE FOR THE PAIN ASSOCIATED WITH
PERICARDITIS.
WHICH ASSESSMENT FINDING FOR A PATIENT WITH INFECTIVE ENDOCARDITIS IS
CONSISTENT WITH
EMBOLIZED VEGETATIONS FROM THE TRICUSPID VALVE?
A. FLANK PAIN
B. SPLENOMEGALY
C. SHORTNESS OF BREATH
D. MENTAL STATUS CHANGES
SHORTNESS OF BREATH
THE NURSE IS OBTAINING A HEALTH HISTORY FROM A 24-YR-OLD PATIENT WITH
HYPERTROPHIC
CARDIOMYOPATHY (CMP). WHICH INFORMATION OBTAINED BY THE NURSE IS MOST
IMPORTANT IN
PLANNING CARE?
A. THE PATIENT HAD A RECENT UPPER RESPIRATORY INFECTION.
B. THE PATIENT HAS A FAMILY HISTORY OF CORONARY ARTERY DISEASE.
C. THE PATIENT REPOR TS USING COCAINE ―A FEW TIMES‖ AS A TEEN AGER.
D. THE PATIENT'S 29-YR-OLD BROTHER DIED FROM A SUDDEN CARDIAC ARREST.
THE PATIENT'S 29-YR-OLD BROTHER DIED FROM A SUDDEN CARDIAC ARREST.
ABOUT HALF OF ALL CASES OF HYPERTROPHIC CMP HAVE A GENETIC BASIS, AND IT IS THE
MOST COMMON
CAUSE OF SUDDEN CARDIAC DEATH IN OTHERWISE HEALTHY YOUNG PEOPLE. THE
INFORMATION ABOUT THE
PATIENT'S BROTHER WILL BE HELPFUL IN PLANNING CARE (E.G., AN AUTOMATIC
IMPLANTABLE
CARDIOVERTER-DEFIBRILLATOR [AICD]) FOR THE PATIENT AND IN COUNSELING OTHER
FAMILY MEMBERS.
THE PATIENT SHOULD BE COUNSELED AGAINST THE USE OF STIMULANT DRUGS, BUT THE
LIMITED PAST HISTORY
INDICATES THAT THE PATIENT IS NOT CURRENTLY AT HIGH RISK FOR COCAINE USE. VIRAL
INFECTIONS AND
CAD ARE RISK FACTORS FOR DILATED CARDIOMYOPATHY BUT NOT FOR HYPERTROPHIC
CMP.
WHICH PATIENT WILL NEED THE NURSE TO PLAN DISCHARGE TEACHING ABOUT
PROPHYLACTIC ANTIBIOTICS
BEFORE DENTAL PROCEDURES?
A. PATIENT ADMITTED WITH A LARGE ACUTE MYOCARDIAL INFARCTION
B. PATIENT BEING DISCHARGED AFTER AN EXACERBATION OF HEART FAILURE
C. PATIENT WHO HAD A MITRAL VALVE REPLACEMENT WITH A MECHANICAL VALVE
D. PATIENT BEING TREATED FOR RHEUMATIC FEVER AFTER A STREPTOCOCCAL INFECTION
PATIENT WHO HAD A MITRAL VALVE REPLACEMENT WITH A MECHANICAL VALVE
CURRENT AMERICAN HEART ASSOCIATION GUIDELINES RECOMMEND THE USE OF
PROPHYLACTIC ANTIBIOTICS
BEFORE DENTAL PROCEDURES FOR PATIENTS WITH PROSTHETIC VALVES TO PREVENT
INFECTIVE ENDOCARDITIS
(IE). THE OTHER PATIENTS ARE NOT AT HIGH RISK FOR IE.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
WHICH ADMISSION PRESCRIPTION WRITTEN BY THE HEALTH CARE PROVIDER FOR A
PATIENT ADMITTED WITH
INFECTIVE ENDOCARDITIS (IE) AND A FEVER WOULD BE A PRIORITY FOR THE NURSE TO
IMPLEMENT?
A. ADMINISTER AN IV ANTIBIOTIC.
B. DRAW BLOOD CULTURES FROM TWO SITES.
C. SCHEDULE A TRANSESOPHAGEAL ECHOCARDIOGRAM.
D. GIVE ACETAMINOPHEN (TYLENOL) PRN FOR FEVER.
DRAW BLOOD CULTURES FROM TWO SITES
TREATMENT OF THE IE WITH ANTIBIOTICS SHOULD BE STARTED AS QUICKLY AS POSSIBLE,
BUT IT IS ESSENTIAL
TO OBTAIN BLOOD CULTURES BEFORE STARTING ANTIBIOTIC THERAPY TO OBTAIN
ACCURATE SENSITIVITY RESULTS.
THE ECHOCARDIOGRAM AND ACETAMINOPHEN ADMINISTRATION ALSO SHOULD BE
IMPLEMENTED RAPIDLY, BUT THE BLOOD CULTURES (AND THEN ADMINISTRATION OF THE
ANTIBIOTIC) HAVE THE HIGHEST PRIORITY.
WHICH ASSESSMENT FINDING IN A PATIENT WHO IS ADMITTED WITH INFECTIVE
ENDOCARDITIS (IE) IS MOST
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
THE NURSE IS CARING FOR A PATIENT WITH AORTIC STENOSIS. WHICH ASSESSMENT DATA
WOULD BE MOST
IMPORTANT TO REPORT TO THE HEALTH CARE PROVIDER?
A. THE PATIENT REPORTS CHEST PRESSURE WHEN AMBULATING.
B. A LOUD SYSTOLIC MURMUR IS HEARD ALONG THE RIGHT STERNAL BORDER.
C. A THRILL IS PALPATED AT THE SECOND INTERCOSTAL SPACE, RIGHT STERNAL BORDER.
D. THE POINT OF MAXIMUM IMPULSE (PMI) IS AT THE LEFT MIDCLAVICULAR LINE.
THE PATIENT REPORTS CHEST PRESSURE WHEN AMBULATING.
CHEST PRESSURE (OR PAIN) OCCURRING WITH AORTIC STENOSIS IS CAUSED BY CARDIAC
ISCHEMIA AND
REPORTING THIS INFORMATION WOULD BE A PRIORITY. A SYSTOLIC MURMUR AND
THRILL ARE EXPECTED IN A
PATIENT WITH AORTIC STENOSIS. A PMI AT THE LEFT MIDCLAVICULAR LINE IS NORMAL.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
TWO DAYS AFTER AN ACUTE MYOCARDIAL INFARCTION (MI), A PATIENT REPORTS
STABBING CHEST PAIN THAT
INCREASES WITH A DEEP BREATH. WHICH ACTION WILL THE NURSE TAKE FIRST?
A. AUSCULTATE THE HEART SOUNDS.
B. CHECK THE PATIENT'S TEMPERATURE.
C. GIVE PRN ACETAMINOPHEN (TYLENOL).
D. NOTIFY THE PATIENT'S HEALTH CARE PROVIDER.
AUSCULTATE THE HEART SOUNDS.
THE PATIENT'S CLINICAL MANIFESTATIONS AND HISTORY ARE CONSISTENT WITH
PERICARDITIS, AND THE FIRST
ACTION BY THE NURSE WOULD BE TO LISTEN FOR A PERICARDIAL FRICTION RUB.
CHECKING THE TEMPERATURE
AND NOTIFYING THE HEALTH CARE PROVIDER ARE ALSO APPROPRIATE ACTIONS BUT
WOULD NOT BE DONE
BEFORE LISTENING FOR A RUB. ACETAMINOPHEN (TYLENOL) IS NOT EFFECTIVE FOR
PERICARDITIS PAIN. AN
ANALGESIC WOULD NOT BE GIVEN BEFORE ASSESSMENT OF A NEW SYMPTOM.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
THE NURSE IS CARING FOR A PATIENT WITH MITRAL VALVE REGURGITATION. WHICH
INFORMATION OBTAINED
BY THE NURSE WOULD BE REPORTED TO THE HEALTH CARE PROVIDER IMMEDIATELY?
A. THE PATIENT HAS 4+ PERIPHERAL EDEMA.
B. THE PATIENT HAS DIFFUSE BILATERAL CRACKLES.
C. THE PATIENT HAS A LOUD SYSTOLIC MURMUR ACROSS THE PRECORDIUM.
D. THE PATIENT HAS A PALPABLE THRILL FELT OVER THE LEFT ANTERIOR CHEST.
THE PATIENT HAS DIFFUSE BILATERAL CRACKLES.
CRACKLES THAT ARE AUDIBLE THROUGHOUT THE LUNGS INDICATE THAT THE PATIENT IS
EXPERIENCING SEVERE
LEFT VENTRICULAR FAILURE WITH PULMONARY CONGESTION AND NEEDS IMMEDIATE
INTERVENTIONS SUCH AS
DIURETICS. A SYSTOLIC MURMUR AND PALPABLE THRILL WOULD BE EXPECTED IN A
PATIENT WITH MITRAL
REGURGITATION. ALTHOUGH 4+ PERIPHERAL EDEMA INDICATES A NEED FOR A CHANGE
IN THERAPY, IT DOES
NOT NEED TO BE ADDRESSED URGENTLY.
WHICH ACTION BY THE NURSE WILL DETERMINE IF THERAPIES ORDERED FOR A PATIENT
WITH CHRONIC
