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 A

Explanation

Atropine is an anticholinergic medication that acts by blocking the effects of the parasympathetic nervous system on the heart, leading to an increase in heart rate (positive chronotropic effect) and conduction velocity (positive dromotropic effect). In patients with symptomatic type 1 second degree atrioventricular (AV) block (also known as Mobitz type 1 or Wenckebach), the electrical impulses between the atria and ventricles are delayed or blocked intermittently, resulting in a progressive lengthening of the PR interval until a ventricular beat is dropped.

When atropine is administered to a patient with symptomatic type 1 AV block, it can counteract the increased vagal tone that contributes to the block and help improve the conduction through the AV node. As a result, the heart rate is expected to increase, which is a positive response to the medication.

The other options listed (B) Decrease in premature ventricular contractions, (C) Increase in strength of peripheral pulses, and (D) Decrease in premature atrial contractions, are not directly related to the effect of atropine on type 1 AV block and are not typical findings associated with atropine administration in this context. The main goal of administering atropine in this situation is to increase the heart rate and improve the AV conduction to alleviate symptoms associated with the AV block.

A. "A nitroprusside stress echocardiogram is used for patients with acute pericarditis." B. "A pathologic Q wave is always present in the electrocardiogram (ECG) of patients with unstable angina." C. "Serum cardiac markers are proteins that are released from necrotic heart muscle." D. "Coronary angiography is the only way to confirm the diagnosis of unstable angina."

Correct Answer is C

Explanation

This statement indicates effective learning because serum cardiac markers are indeed proteins that are released from necrotic (damaged) heart muscle cells when there is myocardial injury, such as in acute coronary syndrome (ACS). These markers are measured in blood tests and help in the diagnosis and assessment of ACS, particularly myocardial infarction (heart attack).

Option A is incorrect because a nitroprusside stress echocardiogram is not used for acute pericarditis. It is a diagnostic test used for evaluating coronary artery disease and ischemia.

Option B is incorrect because a pathologic Q wave is not always present in the electrocardiogram (ECG) of patients with unstable angina. It is a characteristic finding in the ECG of patients with a previous myocardial infarction (heart attack) but may not be present in unstable angina.

Option D is incorrect because coronary angiography is not the only way to confirm the diagnosis of unstable angina. Unstable angina is primarily diagnosed based on the clinical presentation, symptoms, and changes in the ECG. Coronary angiography is an invasive procedure used to visualize the coronary arteries directly and is typically reserved for cases where further assessment and intervention are needed, such as in cases of suspected coronary artery disease.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After the nurse gives IV atropine to a patient with symptomatic type 1. second-degree atrioventricular (AV) block, which finding indicates that the drug has been effective?

Correct Answer is A

Explanation

The nurse teaches a student nurse about diagnostic studies used for acute coronary syndrome. Which statement made by the student nurse indicates effective learning?

Correct Answer is C

Explanation

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?

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

The nurse is caring for a patient with manifestations of acute decompensated heart failure (ADHF). What is the priority nursing assessment?

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

A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients? (Select all that apply.)

The nurse on the intermediate care unit received a change-of-shift report on four patients with hypertension. Which patient should the nurse assess first?