A client who has had a myocardial infarction is started on a cardiac rehabilitation program. The client asks the nurse why he must participate in this program. What is the most important information for the nurse to include in answering the client's question?
This program has been ordered by the physician and is required by the health insurance.
Participation will prevent any future events.
Participation has been shown to decrease the risk of subsequent coronary events.
The program includes monitored exercise, and risk reduction counseling.
The Correct Answer is C
A. While physician orders and insurance coverage are reasons for participation, they do not explain the health benefit to the client.
B. Participation cannot completely prevent future events; this statement is inaccurate.
C. Cardiac rehabilitation has been shown to reduce the risk of subsequent coronary events and improve overall cardiovascular outcomes, which is the primary rationale for participation.
D. While describing program components is informative, the focus should be on the health benefit and risk reduction, which is most important to the client.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Dopamine primarily increases cardiac output and blood pressure; CVP is normal, so hypotension is not a concern. Reducing dopamine is not indicated.
B. Epinephrine increases heart rate, contractility, and systemic vascular resistance. SVR is already low, but epinephrine tends to increase SVR at moderate doses, so it is not the primary contributor to low SVR here.
C. Dobutamine primarily increases cardiac output by enhancing contractility. The patient’s CO is already high, but dobutamine does not significantly decrease SVR.
D. Nitroprusside sodium is a potent vasodilator that lowers systemic vascular resistance. In this client, SVR is critically low (400 dynes/sec/cm⁻⁵), contributing to hypotension despite high CO. Reducing the nitroprusside infusion is appropriate to prevent further drops in SVR and maintain adequate perfusion pressure.
Correct Answer is D
Explanation
A. Nitroprusside is a potent vasodilator used to treat hypertensive emergencies, but it is not the first step in managing a drug-induced BP increase from dopamine.
B. Amiodarone is an antiarrhythmic; a bolus is not indicated for hypertension caused by dopamine.
C. Discontinuing dopamine entirely may cause hypotension again; the appropriate action is to titrate the dose according to the order.
D. The order allows titration of dopamine to maintain the target BP (100/70). The client’s BP is now excessively high, indicating the dopamine dose is too strong. The nurse should decrease the infusion rate and monitor BP closely, notifying the physician of the response.
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