PNR 309 Midterm Ch7,30,31,35-37,60 (St Clair College PNR
309 - Nursing Theory IIIB) Questions With Complete
Solutions
A 70-year-old man has just been diagnosed with chronic
obstructive pulmonary disease (COPD). At what point should
the nurse begin to include the client's wife in the teaching
around the management of the disease?
a)As soon as possible
b)When the client requests assistance from his spouse and
family
c)When the client becomes unable to manage his symptoms
independently
d)After the client has had the opportunity to adjust to his
treatment regimen Correct Answers a)As soon as possible
In the management of chronic illness, it is desirable to include
family caregivers in client education and symptom-management
efforts as early in the diagnosis as possible.
A client admitted with heart failure (HF) appears very anxious
and complains of shortness of breath. Which of the following
nursing actions would be appropriate to alleviate this client's
anxiety? (Select all that apply.)
a)Position client in a semi-Fowler's position.
b)Administer ordered morphine sulphate.
c)Position client on left side with head of bed flat.
d)Instruct client on the use of relaxation techniques.
e)Use a calm, reassuring approach while talking to client.
Correct Answers a)Position client in a semi-Fowler's position,
b)Administer ordered morphine sulphate, d)Instruct client on the
,use of relaxation techniques, e)Use a calm, reassuring approach
while talking to client.
Morphine sulphate reduces anxiety and may assist in reducing
dyspnea. Relaxation techniques and a calm reassuring approach
will also serve to reduce anxiety. The client should be positioned
in semi-Fowler's position to improve ventilation.
A client reports having dry mouth and asks for some liquid to
drink. The nurse reasons that this symptom can most likely be
attributed to a common adverse effect of which of the following
medications?
a)Digoxin
b)Esomeprazole
c)Famotidine
d)Promethazine Correct Answers D
A client was admitted to the emergency department 24 hours
earlier with symptoms of chest pain that were subsequently
attributed to ST-segment-elevation myocardial infarction
(STEMI). Which of the following complications of MI should
the nurse anticipate?
a)Unstable angina
b)Cardiac tamponade
c)Sudden cardiac death
d)Cardiac dysrhythmias Correct Answers d)Cardiac
dysrhythmias
The most common complication after MI is dysrhythmias,
which are present in 80% of clients. Unstable angina is
,considered a precursor to MI rather than a complication. Cardiac
tamponade is a rare event, and sudden cardiac death is defined
as an unexpected death from cardiac causes; cardiac dysfunction
in the period following an MI would not be characterized as
sudden cardiac death.
A client who had been diagnosed with lung cancer demonstrates
fatigue, recent weight loss, nausea and vomiting, lethargy and
confusion with personality changes. The nurse suspects:
A client with a diagnosis of heart failure (HF) has been started
on a nitroglycerin patch by his primary care provider. Which of
the following should the nurse teach the client to avoid?
a)High-potassium foods
b)Drugs to treat erectile dysfunction
c)Over-the-counter H2-receptor blockers
d)Nonsteroidal anti-inflammatory drugs (NSAIDs) Correct
Answers b)Drugs to treat erectile dysfunction
The use of erectile dysfunction drugs concurrent with nitrates
creates a risk of severe hypotension. Nonsteroidal anti-
inflammatory drugs (NSAIDs), H2-receptor blockers, and high-
potassium foods do not pose a risk in combination with nitrates.
A client with a history of peptic ulcer disease has presented to
the emergency department with symptoms of severe abdominal
, pain and a rigid, boardlike abdomen, prompting the health care
team to suspect a perforated ulcer. Which of the following
actions should the nurse anticipate?
a)Providing IV fluids and inserting a nasogastric tube
b)Administering oral bicarbonate and testing the client's gastric
pH level
c)Performing a fecal occult blood test and administering IV
calcium gluconate
d)Starting parenteral nutrition and placing the client in a high
Fowler's position Correct Answers A
A perforated peptic ulcer requires IV replacement of fluid losses
and continued gastric aspiration by NG tube. Nothing is given
by mouth, and gastric pH testing is not a priority. Calcium
gluconate is not a medication directly relevant to the client's
suspected diagnosis and parenteral nutrition is not a priority in
the short term.
A client with a recent diagnosis of heart failure (HF) has been
prescribed furosemide in an effort to accomplish which of the
following outcomes?
a)Reduce preload
b)Decrease afterload
c)Increase contractility
d)Promote vasodilation Correct Answers a)Reduce preload
Diuretics such as furosemide are used in the treatment of
(CONGESTIVE) heart failure (HF) to mobilize edematous fluid,
reduce pulmonary venous pressure, and reduce preload. They do
not directly influence contractility, afterload, or vessel tone.
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