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 B

Explanation

Edema is a common finding in clients who have chronic venous insufficiency, due to the impaired venous return and increased capillary pressure. The edema is usually worse at the end of the day and improves with elevation.

a. Thick, deformed toenails are more likely to be seen in clients who have fungal infections or peripheral arterial disease, not chronic venous insufficiency.

c. Dependent rubor is a sign of peripheral arterial disease, not chronic venous insufficiency. It is a reddish color of the lower extremities that occurs when they are lowered and disappears when they are elevated.

d. Hair loss is another sign of peripheral arterial disease, not chronic venous insufficiency. It is caused by the reduced blood supply to the hair follicles.

A. Slow repolarization of ventricular Purkinje fibers B. Atrial depolarization C. Early ventricular repolarization D. Ventricular depolarization

Correct Answer is B

Explanation

The P wave is the first wave on the ECG strip and represents the electrical activity of the atria. It reﬂects the depolarization of the atrial myocardium, which is the process of changing the electrical charge of the cardiac cells from negative to positive, triggering a contraction. The P wave precedes the QRS complex, which represents ventricular depolarization, and the T wave, which represents ventricular repolarization.

The other options are not correct because:

a. Slow repolarization of ventricular Purkinje fibers. This statement is incorrect because it describes the U wave, which is a small and sometimes invisible wave that follows the T wave on the ECG strip. It reﬂects the repolarization of the ventricular Purkinje fibers, which are specialized cardiac cells that conduct electrical impulses to the ventricles. The U wave is more prominent in conditions that cause hypokalemia, such as diuretic use or vomiting.

c. Early ventricular repolarization. This statement is incorrect because it describes the ST segment, which is the ﬂat line between the QRS complex and the T wave on the ECG strip. It reﬂects the early phase of ventricular repolarization, which is the process of restoring the electrical charge of the cardiac cells to negative after a contraction. The ST segment can be elevated or depressed in conditions that cause myocardial ischemia or injury, such as angina or myocardial infarction.

d. Ventricular depolarization. This statement is incorrect because it describes the QRS complex, which is the largest and most visible wave on the ECG strip. It reﬂects the depolarization of the ventricular myocardium, which triggers a ventricular contraction. The QRS complex follows the P wave and precedes the T wave on the ECG strip.

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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?

Nursing Test Bank

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Explanation

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