Which topic will the nurse plan to include in discharge teaching for a client who has heart failure with reduced ejection fraction?

Need to begin an aerobic exercise program several times weekly

Use of salt substitutes to replace table salt when cooking and at the table

Importance of making an annual appointment with the health care provider

Benefits and effects of angiotensin-converting enzyme (ACE) inhibitors

Answer and Explanation

The Correct Answer is D

Discharge teaching for a client with heart failure and reduced ejection fraction should prioritize education about medications that are essential in managing heart failure, such as angiotensin-converting enzyme (ACE) inhibitors.

ACE inhibitors are a class of medications commonly prescribed to heart failure patients with reduced ejection fraction. They work by dilating blood vessels, reducing the workload on the heart, and improving the heart's pumping ability. They are one of the cornerstones of heart failure management and have been shown to reduce symptoms, improve quality of life, and prolong survival in heart failure patients.

Educating the client about the benefits and effects of ACE inhibitors is crucial to promote medication adherence and ensure they understand the importance of taking this medication as prescribed. Common side effects, such as dizziness or dry cough, should also be discussed so the client knows what to expect and when to notify their healthcare provider.

While the other options may also be relevant to a client with heart failure, including starting an aerobic exercise program (A), reducing salt intake (B), and scheduling regular follow-up appointments (C), the immediate priority in discharge teaching should be about the medication regimen and the specific benefits and effects of ACE inhibitors. Other aspects of heart failure management can be addressed during the overall education and follow-up sessions.

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Correct Answer is C

Explanation

The client's presentation of chest pain radiating to the left arm, sweating, shortness of breath, epigastric discomfort, cool and diaphoretic skin, tachycardia, and ST elevation on the electrocardiogram (ECG) are indicative of myocardial infarction (heart attack). These symptoms and findings are typical of acute coronary syndrome, specifically an ST-segment elevation myocardial infarction (STEMI).

Option A (Ischemic Stroke) is not the correct answer because the symptoms described in the client's presentation are primarily related to the cardiovascular system and not indicative of an ischemic stroke.

Option B (Chronic Stable Angina) is not the correct answer because chronic stable angina typically presents with chest pain on exertion or stress, and it usually subsides with rest or nitroglycerin. The client's symptoms of chest pain at rest, along with other findings, are more concerning for an acute cardiac event like a myocardial infarction.

Option D (Cardiogenic Shock) is a severe complication that can occur following a myocardial infarction, but the information provided in the scenario does not suggest that the client is in cardiogenic shock at this time. The client's blood pressure is not mentioned in the scenario, which is a crucial parameter to assess for cardiogenic shock.

A. Permanent pacemakers B. Emergency cardioversion C. IV adenosine (Adenocard) D. Anticoagulant therapy

Correct Answer is D

Explanation

When a patient with dilated cardiomyopathy develops new onset atrial fibrillation (AF) that has been unresponsive to drug therapy, the nurse should prioritize patient education about anticoagulant therapy. Atrial fibrillation increases the risk of blood clots forming in the heart's atria due to the irregular and ineffective pumping of blood. These blood clots can potentially travel to other parts of the body, leading to serious complications such as stroke.

Anticoagulant therapy, also known as blood-thinning medication, is commonly prescribed for patients with atrial fibrillation to prevent the formation of blood clots. The most common anticoagulant prescribed for AF is warfarin or direct oral anticoagulants (DOACs) such as apixaban, rivaroxaban, dabigatran, or edoxaban. The nurse should educate the patient about the importance of taking the anticoagulant as prescribed and the need for regular monitoring of clotting times (INR for warfarin) to ensure the medication is effective and the dose is appropriate.

While other options listed in the choices may be relevant in specific situations, the priority in this case is to address the potential risk of stroke associated with atrial fibrillation and the importance of anticoagulant therapy to manage that risk effectively.

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Which topic will the nurse plan to include in discharge teaching for a client who has heart failure with reduced ejection fraction?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. What topic should the nurse plan to include in patient teaching?

Correct Answer is D

Explanation

The nurse identifies that a patient with chronic kidney disease is at risk for which electrolyte disturbance?

Which diagnostic test will be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure?

Which information is most important for the nurse to include when teaching a client newly diagnosed with hypertension?

Which assessment finding of a patient with chronic kidney disease indicates to the nurse that hemodialysis is having the desired effect?

Which electrocardiographic (ECG) change by a client with chest pain is most important for the nurse to report rapidly to the health care provider?

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Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin?

The nurse is reviewing the laboratory test results for a client who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?