A nurse teaches a client with a new permanent pacemaker. Which instructions would the nurse include in this client’s teaching? (Select all that apply)

“Until your incision is healed, do not submerge your pacemaker. Only take showers.”

“Report any pulse rates lower than your pacemaker settings.”

“If you feel weak, apply pressure over your generator.”

“Have your pacemaker turned off before having magnetic resonance imaging (MRI).”

“Do not lift your left arm above the level of your shoulder for 8 weeks.”

Answer and Explanation

Correct Answer : A,B,E

Choice A reason: Avoiding submersion until the incision heals prevents infection in a new pacemaker site. This aligns with post-implant care, making it a correct instruction the nurse would include to ensure proper healing and device safety for the client.

Choice B reason: Reporting pulse rates below pacemaker settings indicates potential device failure, requiring prompt evaluation. This aligns with pacemaker monitoring, making it a correct instruction the nurse would teach the client to ensure device function and cardiac stability.

Choice C reason: Applying pressure over the generator doesn’t address weakness and may harm the device. Reporting low pulse rates is correct, making this incorrect, as it’s not a valid instruction for the nurse to include in pacemaker teaching.

Choice D reason: Pacemakers aren’t turned off for MRI; MRI-compatible devices or alternatives are used. Arm movement restriction is correct, making this incorrect, as it’s inaccurate compared to the nurse’s proper instructions for pacemaker care and MRI safety.

Choice E reason: Avoiding arm lifting above the shoulder for 8 weeks prevents lead dislodgement in a new pacemaker. This aligns with post-implant restrictions, making it a correct instruction the nurse would include to protect the device’s integrity.

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Correct Answer is C

Explanation

Choice A reason: Nausea and vomiting may occur with nitroglycerin, but depression, fatigue, and impotence are unrelated. Headache and hypotension are primary effects, making this incorrect, as it includes irrelevant symptoms compared to the nurse’s teaching on nitroglycerin’s expected side effects.

Choice B reason: Sedation, constipation, and respiratory depression are opioid effects, not nitroglycerin, which causes vasodilation. Dizziness and flushing are correct, making this incorrect, as it misattributes opioid side effects to nitroglycerin in the nurse’s education for angina management.

Choice C reason: Nitroglycerin causes headache, hypotension, dizziness, and flushing due to vasodilation, common side effects. This aligns with pharmacological education for angina, making it the correct set of symptoms the nurse would teach the client to expect after taking sublingual nitroglycerin.

Choice D reason: Pedal edema is not a nitroglycerin side effect, though flushing, dizziness, and headache are. Hypotension is more precise than edema, making this incorrect, as it includes an unrelated symptom compared to the accurate side effects in nitroglycerin teaching.

Choice E reason: Decreased cardiac output and peripheral edema are not nitroglycerin effects; it improves coronary flow. Flushing is correct, but hypotension is key, making this incorrect, as it misrepresents nitroglycerin’s pharmacological effects in the nurse’s teaching for angina relief.

A. Elevated creatinine level. B. Decreased hemoglobin level. C. Decreased red blood cell count. D. Increased number of white blood cells in the urine.

Correct Answer is A

Explanation

Choice A reason: Elevated creatinine is a hallmark of chronic kidney disease, reflecting reduced glomerular filtration rate. This aligns with renal function assessment, making it the correct finding the nurse would expect in a client with chronic kidney disease based on laboratory results.

Choice B reason: Decreased hemoglobin may occur in chronic kidney disease due to anemia, but it’s less specific than elevated creatinine, a direct renal marker. This is incorrect, as it’s secondary to the nurse’s primary expectation of creatinine elevation in kidney disease.

Choice C reason: Decreased red blood cell count accompanies anemia in kidney disease but is less direct than creatinine, which measures kidney function. This is incorrect, as it’s not the primary finding the nurse would expect compared to elevated creatinine levels.

Choice D reason: Increased white blood cells in urine suggest infection, not a universal finding in chronic kidney disease. Elevated creatinine is more consistent, making this incorrect, as it’s not the nurse’s primary expected lab result in kidney disease assessment.

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A nurse teaches a client with a new permanent pacemaker. Which instructions would the nurse include in this client’s teaching? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is reviewing a client’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Correct Answer is A

Explanation

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