The nurse is educating a client newly diagnosed with coronary artery disease. What statement by the client would lead the nurse to understand more teaching is needed?
I will wear layered clothing when walking outside in winter.
I will walk early in the morning when it is hot outside.
If I get shortness of breath, I should slow down a bit.
My exercise intensity should not exceed my ability to talk.
The Correct Answer is B
A. "I will wear layered clothing when walking outside in winter": This statement shows an understanding of the need to dress appropriately for weather conditions, which is important in managing symptoms during physical activity.
B. "I will walk early in the morning when it is hot outside": This statement indicates a lack of understanding regarding the ideal timing for outdoor activities, especially in hot weather. Exercising during the cooler parts of the day (such as early morning or late evening) is recommended to avoid heat-related stress and potential exacerbation of cardiovascular symptoms.
C. "If I get shortness of breath, I should slow down a bit": This statement demonstrates an understanding of monitoring symptoms during exercise and adjusting activity levels accordingly, which is an important aspect of managing coronary artery disease.
D. "My exercise intensity should not exceed my ability to talk": This statement reflects an understanding of the recommended exercise intensity level based on the ability to talk comfortably during physical activity, known as the "talk test."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Administer aspirin:
Aspirin is commonly given to patients suspected of having a heart attack because it helps to inhibit platelet aggregation and reduce the risk of further clot formation. However, the administration of aspirin typically follows the confirmation of a cardiac event through diagnostic tests like the ECG. Aspirin is not the initial priority compared to obtaining diagnostic data.
B. 12 Lead Electrocardiography (ECG):
This is the most critical and time-sensitive action because it helps to quickly assess the patient's cardiac status. A 12 Lead ECG can identify important findings such as ST-segment elevation or depression, which are indicative of acute myocardial infarction (heart attack) or other cardiac abnormalities. Early detection and intervention are crucial in improving outcomes for patients with suspected cardiac events.
C. Assess vital signs:
Vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, provide valuable information about the patient's overall condition and can help determine the severity of the cardiac event. While assessing vital signs is important, performing the ECG takes precedence due to its immediate relevance in diagnosing and managing a potential cardiac emergency.
D. Administer morphine:
Morphine may be indicated for pain relief in patients with acute coronary syndromes. However, its administration should be based on the patient's pain level, hemodynamic stability, and other factors assessed after obtaining the ECG and vital signs. Morphine administration is not the primary action within the first 10 minutes of the patient's arrival; it follows the initial assessment and diagnostic procedures.
Correct Answer is ["B","E"]
Explanation
A. Confirm that the room number matches the medical record.Room numbers should never be used as a sole method to identify a client. Room assignments can change, and relying on them could lead to errors.
B. Compare the client identification number to the blood component tag number.Matching the client identification number to the blood component tag ensures the blood is being administered to the correct client. This is a key step in preventing transfusion errors.
C. Verify the provider's prescription with another RN.While this is an important step in the blood administration process, it is not specifically related to identifying the client.
D. Ask the client to verbalize if the blood type is Rh-negative or positive.Clients may not know their blood type, and relying on their verbal confirmation is unsafe. The blood type must be confirmed through laboratory testing and matched with the blood being administered.
E. Scan the barcode on the client's identification band.Scanning the barcode on the client’s identification band is a reliable and commonly used method for verifying the client’s identity in modern healthcare settings. This ensures that the blood is administered to the correct client.
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