NUR 402 Exam 2 NCLEX Questions with correct
answers
The community health nurse is planning health promotion teaching
targeted at preventing coronary artery disease (CAD). Which of the
following ethnic groups would the nurse select as the highest priority for
this intervention?
A) White male
B) Hispanic male
C) African American male
D) Native American female Correct Answer-A) White male
The incidence of CAD and myocardial infarction (MI) is highest among
white, middle-aged men. Hispanic individuals have lower rates of CAD
than non-Hispanic whites or African Americans. African Americans
have an earlier age of onset and more severe CAD than whites and more
than twice the mortality rate of whites of the same age. Native
Americans have increased mortality in less than 35-year-olds and have
major modifiable risk factors such as diabetes.
Which of the following individuals would the nurse identify as having
the highest risk for CAD?
A) A 45-year-old depressed male with a high-stress job
B) A 60-year-old male with below normal homocysteine levels
C) A 54-year-old female vegetarian with elevated high-density
lipoprotein (HDL) levels
,D) A 62-year-old female who has a sedentary lifestyle and body mass
index (BMI) of 23 kg/m2 Correct Answer-A) A 45-year-old depressed
male with a high-stress job
The 45-year-old depressed male with a high-stress job is at the highest
risk for CAD. Studies demonstrate that depression and stressful states
can contribute to the development of CAD. Elevated HDL levels and
low homocysteine levels actually help to prevent CAD. Although a
sedentary lifestyle is a risk factor, a BMI of 23 kg/m2 depicts normal
weight, and thus the patient with two risk factors is at greatest risk for
developing CAD.
When providing nutritional counseling for patients at risk for CAD,
which of the following foods would the nurse encourage patients to
include in their diet (select all that apply)?
A) Tofu
B) Walnuts
C) Tuna fish
D) Whole milk
E) Orange juice Correct Answer-A) Tofu
B) Walnuts
C) Tuna fish
Tuna fish, tofu, and walnuts are all rich in omega-3 fatty acids, which
have been shown to reduce the risks associated with CAD when
consumed regularly.
,For which of the following antilipemic medications would the nurse
question an order in a patient with cirrhosis of the liver?
A) Niacin (Nicobid)
B) Ezetimibe (Zetia)
C) Gemfibrozil (Lopid)
D) Atorvastatin (Lipitor) Correct Answer-B) Ezetimibe (Zetia)
D) Atorvastatin (Lipitor)
Ezetimibe (Zetia) should not be used by patients with liver impairment.
Adverse effects of atorvastatin (Lipitor), a statin drug, include liver
damage and myopathy. Liver enzymes must be monitored frequently
and the medication stopped if these enzymes increase. Niacin's side
effects subside with time, although decreased liver function may occur
with high doses. Cholestyramine is safe for long-term use.
After teaching a patient with chronic stable angina about nitroglycerin,
the nurse recognizes the need for further teaching when the patient
states,
A) "I will replace my nitroglycerin supply every 6 months."
B) "I can take up to five tablets every 3 minutes for relief of my chest
pain."
C) "I will take acetaminophen (Tylenol) to treat the headache caused by
nitroglycerin."
D) "I will take the nitroglycerin 10 minutes before planned activity that
usually causes chest pain." Correct Answer-B) "I can take up to five
tablets every 3 minutes for relief of my chest pain."
, The recommended dose of nitroglycerin is one tablet taken sublingually
(SL) or one metered spray for symptoms of angina. If symptoms are
unchanged or worse after 5 minutes, the patient should be instructed to
activate the emergency medical services (EMS) system. If symptoms are
improved, repeat the nitroglycerin every 5 minutes for a maximum of
three doses and contact EMS if symptoms have not resolved completely.
The nurse would assess a patient with complaints of chest pain for which
of the following clinical manifestations associated with a myocardial
infarction (MI) (select all that apply)?
A) Flushing
B) Ashen skin
C) Diaphoresis
D) Nausea and vomiting
E) S3 or S4 heart sounds Correct Answer-B) Ashen skin
C) Diaphoresis
D) Nausea and vomiting
E) S3 or S4 heart sounds
During the initial phase of an MI, catecholamines are released from the
ischemic myocardial cells, causing increased sympathetic nervous
system (SNS) stimulation. This results in the release of glycogen,
diaphoresis, and vasoconstriction of peripheral blood vessels. The
patient's skin may be ashen, cool, and clammy (not flushed) as a result of
this response. Nausea and vomiting may result from reflex stimulation of
the vomiting center by severe pain. Ventricular dysfunction resulting
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