A nurse is preparing a client who is scheduled for an echocardiogram the following day. Which of the following instructions should the nurse include about the test?

It requires lying quietly on one side."

It might cause slight discomfort in the chest area."

"It is best to have no food or beverages the day of the test."

"It takes about 5 or 10 minutes."

Answer and Explanation

The Correct Answer is A

A. "It requires lying quietly on one side": This is the correct answer. During an echocardiogram, the client is typically asked to lie on their left side to obtain clear images of the heart. The test is non-invasive and involves using ultrasound waves to create images of the heart's structures.

B. "It might cause slight discomfort in the chest area": Echocardiograms are generally painless and do not cause discomfort. They are a non-invasive imaging technique that uses sound waves.

C. "It is best to have no food or beverages the day of the test": While the client may be instructed to avoid eating or drinking shortly before the test, this statement is too restrictive. The specific fasting instructions will be provided by the healthcare provider or facility.

D. "It takes about 5 or 10 minutes": The duration of an echocardiogram can vary, but it typically takes longer than 5 or 10 minutes. The test duration depends on various factors, including the complexity of the study and the information needed.

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Correct Answer is C

Explanation

A. Impaired tissue perfusion: While impaired tissue perfusion is a concern in clients with varicose veins, the presence of ulcerations indicates that skin integrity is already compromised. Addressing impaired skin integrity is a more immediate concern.

B. Alteration in activity tolerance: Alteration in activity tolerance may be a consequence of impaired tissue perfusion and impaired skin integrity, but the priority is to address the current skin breakdown and prevent further complications.

C. Impaired skin integrity: This is the correct answer. The presence of varicose veins, ulcerations, and lower extremity edema indicates compromised skin integrity. The nurse should prioritize interventions to promote wound healing, prevent infection, and address the underlying causes contributing to impaired skin integrity.

D. Alteration in body image: While body image concerns may arise in clients with varicose veins, the immediate priority is addressing the physical complications such as impaired skin integrity to prevent further deterioration.

A. Bumetanide 1 mg IV bolus every 12 hr B. Laboratory testing of serum potassium upon admission C. 0.9% normal saline IV at 50 mL/hr continuous D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain

Correct Answer is C

Explanation

Correct answer: C

A. Bumetanide 1 mg IV bolus every 12 hr is a loop diuretic used to help reduce fluid overload and manage heart failure symptoms. This medication helps remove excess fluid from the body and can be beneficial for a client with acute heart failure following an MI.

B. Laboratory testing of serum potassium upon admission: It is common to monitor serum potassium levels in patients receiving diuretics, especially loop diuretics, to prevent electrolyte imbalances.

C.Administering 0.9% normal saline IV at a continuous rate can potentially exacerbate heart failure by increasing fluid volume, leading to fluid overload and worsening symptoms. In acute heart failure, fluid management is critical, and fluids are typically restricted to prevent further strain on the heart.

D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain: Morphine sulfate is prescribed for pain management and is commonly used in acute heart failure situations to relieve anxiety and decrease preload on the heart. The dosing frequency is appropriate as "every 2 hr PRN" indicates it should be administered as needed for pain relief.

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A nurse is preparing a client who is scheduled for an echocardiogram the following day. Which of the following instructions should the nurse include about the test?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

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