How it Works
Try Naxlex NCLEX-RN (Free-Trial)

Exhibits

The client was given oxygen, sublingual nitroglycerin, and aspirin. After one dose of nitroglycerin, the client's pain decreased to a reported 2 on a 0 to 10 scale with squeezing pain. The client was admitted for observation and percutaneous coronary intervention (PCI) to be completed later within the evening. The client asks the nurse to explain why a PCI is being completed.
 

select word choices to complete the sentence.

If healthcare providers see a narrowed heart vessel while performing a percutaneous coronary intervention (PCI), they may perform a balloon angioplasty to compress the plaque against the vessel wall and hold it there with a stent, which will lessen

and

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"B"}

  • Heart blocks: Heart blocks result from conduction abnormalities in the electrical pathways of the heart and are typically managed with pacemakers or medications, not directly corrected by PCI. PCI targets mechanical obstructions in the coronary arteries and does not primarily address conduction delays.
  • Dysrhythmias: Restoring blood flow through PCI improves oxygen delivery to the myocardium, stabilizing the heart’s electrical activity. Ischemia often triggers dysrhythmias, and by relieving this ischemia, PCI reduces the risk of abnormal heart rhythms, particularly ventricular arrhythmias.
  • Vasospasms: While vasospasms can cause transient coronary artery narrowing, they are usually managed with medications like calcium channel blockers. PCI is not typically used to treat vasospastic events unless they result in a fixed lesion or underlying atherosclerosis.
  • Pain: Chest pain in this client is likely ischemic in nature due to reduced coronary perfusion. PCI relieves this ischemia by opening narrowed arteries, thereby reducing myocardial oxygen demand mismatch and leading to a significant reduction in chest pain symptoms.


Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Free Nursing Study Resources

Related Questions

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

  • Contractures: Postoperative clients with lower limb amputations are at high risk for developing joint contractures, particularly of the hip and knee. This risk increases when the residual limb remains in a flexed position for extended periods. Orders for the client to lie flat and assume a prone position twice daily are intended to stretch the hip flexors and prevent contracture formation, which can hinder prosthetic fitting and long-term mobility.
  • Infection: Despite no current redness or open drainage, the presence of edema and a surgical incision left open to air puts the client at ongoing risk for infection. Edema can impair tissue perfusion and slow wound healing, creating an environment favorable for bacterial growth. Frequent wound checks and adherence to sterile dressing changes are essential in monitoring for early signs of infection such as redness, warmth, or increased drainage.
  • Pneumonia: Although pneumonia is a risk in postoperative patients with limited mobility and opioid use, this client demonstrates normal respiratory status with clear lungs and is using an incentive spirometer as ordered.
  • Deep vein thrombosis (DVT): The client is receiving prophylactic enoxaparin, which significantly reduces the risk of thrombus formation. Although still important to monitor, the presence of pharmacologic prevention places DVT lower in priority at this time.
  • Neuroma: Neuroma formation, resulting from disorganized nerve healing at the amputation site, typically develops later in recovery. It is not a pressing concern in the immediate postoperative phase compared to infection and contractures, which can develop rapidly if not addressed early.

Correct Answer is []

Explanation

  • Rheumatoid arthritis: The client reports symmetrical joint pain and stiffness in both hands and wrists, worse in the morning, lasting for over three months — a hallmark of early RA. The positive ANA, elevated ESR (35 mm/hr), and x-ray findings of soft tissue swelling with marginal erosions further support the diagnosis. RA is an autoimmune inflammatory disorder affecting small joints symmetrically and causing progressive joint damage.
  • Osteoarthritis: OA typically causes asymmetric joint pain, usually in weight-bearing joints like the knees and hips, and pain is worse with activity, not rest. It does not usually present with systemic signs like elevated ESR, nor with symmetrical swelling or morning stiffness lasting more than 30 minutes. The client's x-ray also shows erosions, which are not typical in OA.
  • Osteoporosis: This condition is asymptomatic until a fracture occurs. It does not cause joint pain, swelling, or stiffness. Osteoporosis affects bone density, not joint linings, and wouldn’t be diagnosed based on soft tissue swelling or ANA/ESR findings. This diagnosis is inconsistent with the client's symptoms.
  • Kyphosis: Kyphosis is a spinal curvature disorder, typically seen in older adults or adolescents with poor posture or compression fractures. It does not cause bilateral hand pain or morning stiffness and is unrelated to the client's described presentation.
  • Educate on disease process and management: Rheumatoid arthritis is a chronic autoimmune condition requiring long-term treatment. Educating the client on medication adherence, symptom monitoring, joint protection, and flare management improves self-care and outcomes.
  • Consult dietician for nutrition and weight loss: With a BMI of 31 kg/m², the client is obese, which adds mechanical stress to joints and worsens inflammation. Dietary counseling can support weight loss, reduce joint load, and improve physical mobility and disease control.
  • Offload bony prominences to prevent pressure injuries: This intervention applies to clients with limited mobility or at risk for pressure ulcers. The client is ambulatory and active, so this is not relevant in rheumatoid arthritis management or appropriate for her current function level.
  • Begin total parenteral nutrition: TPN is used in clients who cannot meet nutritional needs orally, often due to severe GI dysfunction. The client is eating and has no nutritional deficits, so this invasive intervention is unnecessary and inappropriate.
  • Turn every two hours: This strategy prevents skin breakdown in bedbound or immobilized patients. The client is independently mobile and not at risk for pressure injuries, so routine turning is not a relevant nursing action in this scenario.
  • Pain: Pain reflects disease activity and guides treatment effectiveness. Monitoring pain regularly helps the healthcare team evaluate flare-ups and adjust therapy accordingly to improve the client's daily functioning and comfort.
  • Physical mobility: RA progressively affects joint function, and tracking mobility allows early identification of limitations. Monitoring changes in mobility helps tailor physical therapy and occupational therapy interventions to preserve independence.
  • Skin breakdown: Skin monitoring is essential for high-risk patients with immobility or incontinence. The client has no such risks or current issues with skin integrity, making this parameter less relevant to her condition and care needs.
  • Blood glucose: Though there is a family history of diabetes, the client has no personal diagnosis and is not on corticosteroids. Monitoring blood glucose is not indicated unless treatment includes glucose-altering medications or diabetes is present.
  • Intake and output: Fluid balance tracking is important in clients with renal, cardiac, or acute illness concerns. In this outpatient client with stable vitals and no comorbidities affecting hydration, intake and output monitoring is not required.

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Register