A 29-year-old woman presents to the ER with chest pain that started this evening. She has experienced episodes like this before which typically occur in the evening and resolve by the next morning. The client has a medical history of migraines and Raynaud’s disease.

Temp: 98 F

BP: 119/72 mm/Hg

HR: 99 bpm

RR: 16 bpm

SpO2: 96% RA

An EKG is completed and indicates no evidence of myocardial infarction but supports the diagnosis of Prinzmetal angina. The nurse finds the client crying starting. “I’m so young, how can my heart arteries be clogged? I eat healthy and the doctor said my cholesterol was normal.” What is the nurses best response?

“This condition is caused by the coronary arteries spasming, not by cholesterol.”

“Just because you’re young and eat right doesn’t mean you can’t have plague buildup.”

“I understand it can be upsetting to have coronary artery disease at your age.”

“I am sure everything will be alright.’’

Answer and Explanation

The Correct Answer is A

A. “This condition is caused by the coronary arteries spasming, not by cholesterol.”: Providing accurate, factual information about Prinzmetal angina addresses the client’s confusion and anxiety. Explaining that the condition is due to coronary artery spasm, rather than atherosclerotic plaque, helps correct misconceptions and empowers the client.

B. “Just because you’re young and eat right doesn’t mean you can’t have plaque buildup.”: Prinzmetal angina is not caused by plaque buildup. It may increase anxiety and confusion rather than providing helpful education.

C. “I understand it can be upsetting to have coronary artery disease at your age.”: While empathetic, this statement reinforces a misunderstanding. The client does not have typical coronary artery disease from plaque; education about the actual condition is appropriate.

D. “I am sure everything will be alright.”: Providing reassurance without education does not address the client’s concern or correct her misconceptions. It may minimize her feelings and fail to provide necessary understanding of the condition.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. “There should be no problem with drinking wine with dinner each night.”: Alcohol can irritate the bladder and worsen urinary symptoms in clients with BPH, including urgency, frequency, and nocturia. This statement indicates the client needs further education about dietary and lifestyle modifications to manage symptoms.

B. “I am so glad that I weaned myself off of coffee about a year ago.”: Caffeine can exacerbate urinary symptoms, so avoiding coffee demonstrates understanding of symptom management. No further teaching is needed for this statement.

C. “I need to inform my allergist that I cannot take my normal antihistamine.”: Antihistamines can cause urinary retention in BPH clients, so informing the provider shows understanding of potential medication-related complications.

D. “My routine of drinking a quart (liter) of water first thing in the morning needs to change”: Excessive fluid intake at once can worsen urinary frequency and urgency. Recognizing the need to adjust this habit shows appropriate understanding of BPH management.

A. Encourage visitors in the early evening, B. Keep the client on fall risk precautions until discharge. C. Check on the client once a shift. D. Place all four side rails in the “up” position.

Correct Answer is B

Explanation

A. Encourage visitors in the early evening: While social support is beneficial, encouraging visitors does not directly prevent falls and may even contribute to confusion or distraction if the client is unstable.

B. Keep the client on fall risk precautions until discharge: Maintaining fall precautions consistently throughout the hospital stay helps prevent falls, especially in clients at high risk. This includes measures such as using non-slip footwear, keeping the call light within reach, and ongoing supervision.

C. Check on the client once a shift: Checking only once per shift is insufficient to prevent falls. Frequent monitoring and timely assistance with mobility are essential for fall prevention.

D. Place all four side rails in the “up” position: Raising all side rails can increase the risk of injury if the client attempts to climb over them and is not considered a safe fall prevention practice for adults.

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Naxlex Comprehensive Predictor Exams

A nurse teaching a client diagnosed with benign prostatic hyperplasia (BPH). What statement indicates the client needs further information?

Correct Answer is A

Explanation

A client is admitted and is placed on fall precautions. The nurse teaches the client and family about fall precautions. Which action will the nurse take to promote client safely?

Correct Answer is B

Explanation

A client with genital herpes has painful blisters on her vulva. After teaching the client self-care measures, which statement indicates the need for further education?

On admission to the burn unit, a client with an appropriate 25% total body surface area (TBSA) burn has the following initial laboratory results: Hct 59%, Hgb 19.2 mg/dL, Serum K 5.0 mEq/L and serum Na 150 mEq/L. Which action will the nurse anticipate taking now?

After teaching a client who has an Implantable cardioverter-defibrillator (ICD), a nurse assesses the client’s understanding. Which statement by the client indicates a correct understanding of the teaching?

A client with circumferential full thickness burns of both legs develops a decrease in dorsalis pedis pulse strength and numbness in the toes. Which action should the nurse take?

A nurse assesses a client after administering the first dose of a nitrate. The client reports a headache. What action would the nurse take?

After the nurse receives report, which client should the nurse assess first?

A nurse is caring for several clients at risk for shock. Which laboratory value requires the nurse to communicate with the primary health care provider?