A male client with angina pectoris is being discharged from the hospital. Which instruction should the nurse plan to include in his discharge teaching?

Keep nitroglycerin in a light-colored plastic bottle and readily available.

Avoid isometric exercises, but walk regularly.

Walk briskly in cold weather to increase cardiac output.

Engage in physical exercise immediately after eating to help decrease cholesterol levels.

Answer and Explanation

The Correct Answer is B

A. Keep nitroglycerin in a light-colored plastic bottle and readily available: Nitroglycerin should be stored in its original dark glass container to protect it from light, heat, and moisture, all of which can reduce its potency.

B. Avoid isometric exercises, but walk regularly: Isometric exercises can sharply increase blood pressure and cardiac workload, potentially triggering angina. In contrast, regular walking improves cardiovascular health without the abrupt rise in myocardial oxygen demand.

C. Walk briskly in cold weather to increase cardiac output: Cold weather causes vasoconstriction, which increases cardiac workload and can provoke angina. Brisk walking in such conditions is risky for clients with coronary artery disease and should be avoided.

D. Engage in physical exercise immediately after eating to help decrease cholesterol levels: Exercising immediately after a meal diverts blood away from digestion, which can strain the heart and trigger angina. Exercise should be scheduled at least 1–2 hours after meals to avoid postprandial angina.

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Correct Answer is B

Explanation

A. Assist with ambulation in the hallway: While progressive ambulation is part of cardiac rehabilitation, early ambulation too soon after a myocardial infarction may increase myocardial oxygen demand and cardiac workload.

B. Provide a bedside commode for toileting: Using a bedside commode reduces the effort and energy expenditure required to walk to the bathroom, thus lowering cardiac workload. This helps prevent unnecessary increases in heart rate and oxygen demand.

C. Encourage active range of motion exercise: Active range of motion is beneficial for preventing complications like thromboembolism, but if done too aggressively or frequently early post-MI, it can stress the heart.

D. Teach to sleep in a side-lying position: Sleeping position may affect comfort and breathing but does not significantly influence cardiac workload. Semi-Fowler’s position may be more beneficial in reducing preload in cardiac patients than simply lying on the side.

A. Evaluate complete blood cell counts. B. Assess for paradoxical pulse. C. Discontinue anticoagulants. D. Monitor central venous pressure (CVP).

Correct Answer is B

Explanation

A. Evaluate complete blood cell counts: While baseline labs, including CBC, are useful, they are not the immediate priority before a pericardiocentesis. These values provide general health data but do not guide acute decision-making for cardiac tamponade.

B. Assess for paradoxical pulse: A paradoxical pulse an exaggerated drop in systolic blood pressure during inspiration is a hallmark sign of cardiac tamponade. Recognizing this finding helps confirm clinical suspicion and prioritize urgent intervention.

C. Discontinue anticoagulants: Stopping anticoagulants is important to prevent bleeding during the procedure, this must be done under provider guidance and may not be feasible if the situation is emergent. It is a safety consideration but not the most urgent nursing action.

D. Monitor central venous pressure (CVP): CVP monitoring can reflect rising intrapericardial pressure in tamponade but often requires invasive access and may not be immediately available. It provides supportive data, but clinical signs such as paradoxical pulse offer more immediate diagnostic relevance.

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A male client with angina pectoris is being discharged from the hospital. Which instruction should the nurse plan to include in his discharge teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is B

Explanation

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