A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following comments made by the client should indicate to the nurse that the client requires further teaching?

"I'll skip my coﬀee the morning of my test."

"I'll take my heart medications the morning of my test."

"I'll get 8 hours of sleep the night before the test."

"I will not smoke prior to my test."

Answer and Explanation

The Correct Answer is B

An exercise stress test is a diagnostic procedure that measures the heart's response to physical activity. The client is instructed to walk on a treadmill or pedal a stationary bike while their heart rate, blood pressure, and electrocardiogram are monitored. The test can help detect coronary artery disease, arrhythmias, or other cardiac problems.

The client should follow certain guidelines before the test, such as:

Avoiding caﬀeine, nicotine, alcohol, and stimulants for at least 4 hours before the test, as they can aﬀect the heart rate and blood pressure.
Fasting for at least 2 hours before the test, as eating can aﬀect the blood ﬂow to the heart.
Getting adequate rest and sleep the night before the test, as fatigue can aﬀect the performance and results of the test.
Wearing comfortable clothing and shoes that are suitable for exercise.
Informing the provider of any medications they are taking, as some medications may need to be withheld or adjusted before the test, such as beta blockers, calcium channel blockers, nitrates, or antiarrhythmics. These medications can aﬀect the heart rate and blood pressure and interfere with the interpretation of the test results.

Therefore, the comment made by the client that indicates a need for further teaching is "I'll take my heart medications the morning of my test." The client should consult with their provider about whether they should take their heart medications or not before the test. The other comments made by the client are appropriate and indicate that they understand the pre-test instructions.

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Correct Answer is C

Explanation

Choice A reason:

This statement is incorrect because it trivializes the patient's concerns and implies that enjoyment is the primary goal, which is not the case. The main purpose of cardiac rehabilitation is to improve health outcomes, not just to make the routine enjoyable.

Choice B reason:

While exercise is beneficial for heart health, this statement is too general and does not address the specific benefits of cardiac rehabilitation for someone who has had a myocardial infarction.

The correct answer is C:

"Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely." Cardiac rehabilitation is crucial for patients who have experienced a myocardial infarction. It provides a structured program that includes exercise, education, and support to help patients improve their cardiovascular health and prevent future cardiac events.

Choice D reason:

Deferring to the doctor's expertise does not educate the patient about the benefits of cardiac rehabilitation. It's important for patients to understand why they are participating in the program.

A. "I'll be glad when I can stop taking this medicine." B. "I have made an appointment to see my dentist next week." C. "I will notify my doctor before taking any other medications." D. "I know that I cannot switch brands of this medication."

Correct Answer is A

Explanation

Phenytoin is an anticonvulsant medication that is used to prevent and treat seizures. It works by stabilizing the electrical activity of the brain and reducing the spread of abnormal impulses. Phenytoin is usually taken for life or until the seizures are controlled by other means, such as surgery or diet. The client should not stop taking phenytoin without consulting their doctor, as this can cause withdrawal symptoms or increase the risk of seizures.

The other options are correct and indicate that the client understands the discharge teaching because:

"I have made an appointment to see my dentist next week." This statement is correct because phenytoin can cause gingival hyperplasia, which is an overgrowth of gum tissue that can lead to bleeding, infection, or difficulty chewing. The client should practice good oral hygiene and see their dentist regularly to prevent or treat this condition.

"I will notify my doctor before taking any other medications." This statement is correct because phenytoin can interact with many other medications, such as antibiotics, anticoagulants, oral contraceptives, or antacids. These interactions can aﬀect the blood levels and eﬀectiveness of phenytoin or the other medications, causing adverse eﬀects or reduced seizure control. The client should inform their doctor of any other medications they are taking or planning to take, including over-the-counter, herbal, or dietary supplements.
"I know that I cannot switch brands of this medication." This statement is correct because diﬀerent brands of phenytoin may have diﬀerent formulations or bioavailability, which can aﬀect the absorption and metabolism of the drug. Switching brands can cause changes in the blood levels and eﬀectiveness of phenytoin, leading to toxicity or reduced seizure control. The client should always use the same brand of phenytoin and check with their pharmacist if they notice any changes in the appearance or labeling of their medication.

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A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following comments made by the client should indicate to the nurse that the client requires further teaching?

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Correct Answer is C

Explanation

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is A

Explanation

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