A nurse is planning care for a client who is recovering from an acute myocardial infarction that occurred 3 days ago. Which of the following interventions should the nurse include?

Perform an ECG every 12 hr.

Obtain a cardiac rehabilitation consultation.

Draw a troponin level every 4 hr.

Place the client in a supine position while resting.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Perform an ECG every 12 hr: Frequent ECGs are typically done during the acute phase to monitor for arrhythmias, but by day 3 post-MI, continuous or as-needed monitoring is more appropriate unless new symptoms occur.

B. Obtain a cardiac rehabilitation consultation: Early involvement of cardiac rehab supports gradual activity progression, lifestyle modification, and psychosocial support, improving long-term outcomes after MI.

C. Draw a troponin level every 4 hr: Troponin testing is most useful for diagnosing and trending damage during the first 24 hours; by day 3, levels have usually peaked and are declining.

D. Place the client in a supine position while resting: Supine positioning can increase cardiac workload; a semi-Fowler's position is preferred to reduce venous return and ease breathing.

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Correct Answer is C

Explanation

A. Personalize the conflict: Making a conflict personal can increase tension and defensiveness among staff. Effective negotiation requires addressing issues objectively rather than targeting individuals.

B. Identify solutions prior to negotiation: Preselecting solutions may limit collaborative problem-solving. Effective negotiation involves exploring options with all parties to reach mutually acceptable outcomes.

C. Attempt to understand both sides of the issue: Understanding each party’s perspective promotes open communication, trust, and collaboration. This approach helps identify common ground and develop solutions that are acceptable to all involved.

D. Focus on how the conflict occurred: Concentrating on past events can create blame and hinder forward-focused problem-solving. Effective negotiation emphasizes current needs and potential solutions rather than dwelling on the cause.

A. Dietitian B. Physical therapy C. Case manager D. Social services

Correct Answer is B

Explanation

Rationale:

A. Dietitian: A dietitian focuses on nutritional needs, which may be beneficial if the client has dietary concerns, but this does not directly address mobility issues related to lower extremity weakness.

B. Physical therapy: Physical therapists specialize in improving strength, balance, and mobility. A referral will help the client develop exercises and strategies to enhance function and reduce fall risk.

C. Case manager: A case manager coordinates healthcare services, but they do not directly provide rehabilitation for weakness. They may be involved later to arrange additional resources after therapy needs are determined.

D. Social services: Social services assist with psychosocial needs, financial support, and community resources, but they are not the primary referral for addressing physical mobility limitations.

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A nurse is planning care for a client who is recovering from an acute myocardial infarction that occurred 3 days ago. Which of the following interventions should the nurse include?

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A nurse is planning care for a client who is recovering from an acute myocardial infarction that occurred 3 days ago. Which of the following interventions should the nurse include?