Pediatric Cardiac Disorders NCLEX Questions Quizlet
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Question 1 of 5.
The male client states to the nurse, “I've recovered after having my new artificial heart valve inserted. Now I want to have a vasectomy so I don't get my wife pregnant.†What is the nurse's best response?
A. “That's probably not a good idea. You could get an infection and damage the new valve.â€
B. “You seem relieved that surgery was successful and that you can enjoy a normal life again.â€
C. “Be sure to take a nitroglycerin tablet before sexual intercourse to prevent any chest pain.â€
D. “Inform your surgeon about the new valve so antibiotics are prescribed before the procedure.â€
Explanation: The surgeon should be aware of the artificial heart valve because antibiotics are required prior to invasive procedures to prevent complications such as endocarditis. The client is also taking an anticoagulant and would be at risk for bleeding. Other responses are incorrect or irrelevant.
Question 2 of 5.
The nurse is developing a discharge-teaching plan for the client diagnosed with congestive heart failure. Which interventions should be included in the plan? Select all that apply.
A. Notify the health-care provider of a weight gain of more than one (1) pound in a week.
B. Teach the client how to count the radial pulse when taking digoxin, a cardiac glycoside.
C. Instruct the client to remove the saltshaker from the dinner table.
D. Encourage the client to monitor urine output for change in color to become dark.
E. Discuss the importance of taking the loop diuretic furosemide at bedtime.
Explanation: Weight gain monitoring (A) detects fluid retention, pulse counting (B) ensures digoxin safety, and removing salt (C) reduces sodium intake. Dark urine (D) is not specific, and furosemide at bedtime (E) causes nocturia, so morning dosing is preferred.
Question 3 of 5.
The nurse is assessing the client diagnosed with congestive heart failure. Which laboratory data would indicate that the client is in severe congestive heart failure?
A. An elevated B-type natriuretic peptide (BNP).
B. An elevated creatine kinase (CK-MB).
C. A positive D-dimer.
D. A positive ventilation/perfusion (V/Q) scan.
Explanation: Elevated BNP (A) is specific to heart failure, reflecting ventricular stress. CK-MB (B) indicates myocardial infarction, D-dimer (C) suggests clotting, and V/Q scan (D) is for pulmonary embolism.
Question 4 of 5.
The nurse and an unlicensed assistive personnel (UAP) are caring for four clients on a telemetry unit. Which nursing task would be best for the nurse to delegate to the UAP?
A. Assist the client to go down to the smoking area for a cigarette.
B. Transport the client to the intensive care unit (ICU) via a stretcher.
C. Provide the client going home discharge-teaching instructions.
D. Help position the client who is having a portable x-ray done.
Explanation: Positioning for an x-ray (D) is within the UAP's scope and safe. Smoking (A) is inappropriate, ICU transport (B) requires nursing judgment, and discharge teaching (C) is a nursing responsibility.
Question 5 of 5.
The nurse has written an outcome goal 'demonstrates tolerance for increased activity' for a client diagnosed with congestive heart failure. Which intervention should the nurse implement to assist the client to achieve this outcome?
A. Measure intake and output.
B. Provide two (2)g sodium diet.
C. Weigh the client daily.
D. Plan for frequent rest periods.
Explanation: Frequent rest periods (D) prevent overexertion, supporting activity tolerance in CHF. Intake/output (A), sodium diet (B), and daily weights (C) are important but less directly related to activity.
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