The nurse provides discharge teaching to a client who had a myocardial infarction.
Which statements by the client indicate an understanding? Select all that apply.

I will call the provider for chest pain.

I will gradually increase activity.

I will utilize a diet rich in polyunsaturated fats.

I will use increasing upper body weights to build muscle.

I will take medications as prescribed.

Answer and Explanation

Correct Answer : A,B,C,E

Post-myocardial infarction discharge teaching focuses on secondary prevention and cardiac rehabilitation. Knowledge of cardiovascular physiology, lifestyle modification, and pharmacology is necessary to ensure the client understands how to reduce cardiac workload and prevent further coronary artery occlusion or heart failure.

Choice A rationale

Reporting chest pain is critical as it indicates potential myocardial ischemia. Early intervention can prevent further muscle damage. Clients must understand that any recurrence of angina requires immediate medical evaluation to assess coronary artery patency and perfusion.

Choice B rationale

Gradual activity increase is a hallmark of cardiac rehabilitation. It allows the heart muscle to adapt to increased demands without causing excessive strain or rupture. Controlled exercise improves cardiovascular efficiency and lowers the resting heart rate over time.

Choice C rationale

Polyunsaturated fats help lower low density lipoprotein cholesterol, reducing the risk of further atherosclerosis. A heart healthy diet limits saturated fats and trans fats, which are known to contribute to plaque formation within the coronary arteries.

Choice D rationale

Heavy weightlifting or isometric exercises can significantly increase systemic vascular resistance and blood pressure. This places excessive afterload on the healing myocardium. Clients are usually advised to avoid heavy lifting or straining during the initial recovery phase.

Choice E rationale

Adherence to medications such as beta blockers, antiplatelets, and statins is vital for long term survival. These drugs reduce blood pressure, prevent clot formation, and stabilize plaques, directly impacting the prevention of a secondary cardiac event.

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Correct Answer is C

Explanation

Educating a patient with atrial fibrillation requires applying knowledge of cardiac hemodynamics and the coagulation cascade. The nurse must focus on how ineffective atrial contractions lead to blood stasis, increasing the probability of clot formation and subsequent systemic embolization.

Choice A rationale

Atrial fibrillation does not directly cause hyperglycemia. While the stress of an acute arrhythmia might slightly elevate blood glucose due to cortisol release, it is not a primary complication or a major risk specifically linked to this rhythm.

Choice B rationale

Diabetic retinopathy is a microvascular complication resulting from chronic poor glucose control over many years. It is not exacerbated or caused by the onset of atrial fibrillation, which is a macrovascular and electrical conduction issue of the heart.

Choice C rationale

In atrial fibrillation, the atria quiver instead of contracting effectively, allowing blood to pool in the left atrial appendage. This stasis leads to thrombus formation; if a clot dislodges, it can travel to the brain.

Choice D rationale

Diabetic ketoacidosis is typically triggered by infection, insulin omission, or extreme physiological stress in Type 1 diabetics. While an arrhythmia is a stressor, the most specific and dangerous direct risk of atrial fibrillation remains systemic thromboembolism

A. "As a nurse, I am required by law to report any suspicion of child abuse.”. B. "The hospital policy requires all injuries to be reported.”. C. "I reported this because I believe abuse has occurred.”. D. "You should speak with the provider about this concern.”.

Correct Answer is A

Explanation

Reporting suspected child abuse involves legal and ethical obligations of healthcare professionals. Knowledge of mandatory reporting laws, professional responsibility, and communication techniques for maintaining a professional boundary while disclosing required actions to concerned or upset parents is essential for this response.

Choice A rationale

Nurses are mandated reporters under the law. Stating this legal requirement provides a factual, non-judgmental explanation for the action. It frames the report as a professional obligation rather than a personal accusation against the upset parents.

Choice B rationale

Referring only to hospital policy is insufficient and potentially misleading. While policies exist, the primary driver for reporting suspected abuse is state law. This response lacks the necessary emphasis on the broader legal and ethical mandates of nursing.

Choice C rationale

This statement is subjective and accusatory, which can escalate a volatile situation. Nurses are required to report suspicion rather than provide a definitive belief of guilt. This phrasing undermines the objective nature of the mandatory reporting process.

Choice D rationale

Deflecting the concern to the provider is inappropriate because the nurse has an independent legal responsibility to report. Avoiding the parents question does not address the nurses role or the legal necessity of the report that was filed.

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The nurse provides discharge teaching to a client who had a myocardial infarction. Which statements by the client indicate an understanding? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A nurse is educating a Type 1 diabetic client with new-onset atrial fibrillation about the risks associated with the condition. Which complications should the nurse emphasize?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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The nurse provides discharge teaching to a client who had a myocardial infarction.
Which statements by the client indicate an understanding? Select all that apply.