Cardiac Nursing Questions (41-45)
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41. The nurse is teaching a client with cardiomyopathy about home care safety measures. The nurse provides instructions on which most important measure to ensure client safety?
a) reporting pain
b) taking vasodilators
c) avoiding over-the-counter medications
d) moving slowly from a sitting to a standing position
42. The nurse instructs a client with a diagnosis of atrial fibrillation to use an electric razor for shaving. The nurse tells the client that the importance of its use is that:
a) cuts need to be avoided
b) any cut may cause infection
c) electric razors can be disinfected
d) all straight razors contain bacteria
43. A cardiac catheterization, using the femoral artery approach, is performed to assess the degree of coronary artery thrombosis in a client. Which nursing action following the procedure is unsafe for the client?
a) encouraging the client to increase fluid intake
b) placing the client’s bed in the fowler’s position
c) resuming prescribed precatheterization medications
d) instructing the client to move the toes when checking circulation, motion, and sensation
44. The nurse is receiving a client being transferred from the postanesthesia care unit following an above-the-knee amputation. The nurse should take which action to safely position the client at this time?
a) elevate the foot of the bed
b) position the residual limb flat on the bed
c) put the bed in reverse trendelenburg’s position
d) keep the residual limb flat with the client lying on the operative side
45. The postmyocardial infarction client is scheduled for a technetium-99m ventriculography (multigated acquisition [MUGA] scan). The nurse ensures that which item is in place before the procedure?
a) a foley catheter
b) signed informed consent
c) a central venous pressure (CVP) line
d) notation of allergies to iodine or shellfish
Cardiac Nursing Questions
Answers and Rationale
- Orthostatic changes can occur in the client with cardiomyopathy as a result of venous return obstruction. Sudden changes in blood pressure may lead to falls. Vasodilators are not normally prescribed for the client with cardiomyopathy. Options A and C, although important, are not directly related to the issue of safety.
- Clients with atrial fibrillation are placed on anticoagulants to prevent thrombus formation and possible stroke. The importance of use of an electric razor is to prevent cuts and possible bleeding. Options B, C, and D are all unrelated to the subject of bleeding; rather, they relate to infection.
- Immediately following a cardiac catheterization with the femoral artery approach, the client should not flex or hyperextend the affected leg to avoid blood vessel occlusion or hemorrhage. Placing the client in the Fowler’s position (flexion) increases the risk of occlusion or hemorrhage. Fluids are encouraged to assist in removing the contrast medium from the body. The precatheterization medications are needed to treat acute and chronic conditions. Asking the client to move the toes is done to assess motion, which could be impaired if a hematoma or thrombus was developing.
- Edema of the residual limb is controlled by elevating it on pillows or the foot of the bed for the first 24 hours only after surgery. Following the first 24 hours, the residual limb is usually placed flat on the bed to reduce hip contracture. Edema is also controlled by residual limb wrapping techniques. Reverse Trendelenburg’s position does not provide direct limb elevation.
- MUGA is a radionuclide study used to detect myocardial infarction, decreased myocardial blood flow, and left ventricular function. A radioisotope is injected intravenously. Therefore, a signed informed consent is necessary. A Foley catheter and CVP line are not required. The procedure does not use radiopaque dye; therefore, allergy to iodine and shellfish is not a concern.
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