The nurse is caring for a male patient, age 54, who had a myocardial infarction 2 days ago. His wife, who is very talkative, has remained at his bedside. Which of these interventions should the nurse implement to reduce the workload of the heart? (Select all that apply.)

Administer daily stool softener.

Provide bedside commode.

Advocate for rest periods with no visitors.

Provide regular diet.

Ambulate four times a day.

Maintain bedrest.

Answer and Explanation

Correct Answer : A,B,C,F

Choice A reason: Administering a daily stool softener can help prevent straining during bowel movements, which can increase cardiac workload.

Choice B reason: Providing a bedside commode reduces the effort required to go to the bathroom, thus reducing cardiac workload.

Choice C reason: Advocating for rest periods with no visitors can help reduce emotional stress and physical exertion, which can increase cardiac workload.

Choice D reason: A regular diet is not specifically an intervention to reduce cardiac workload and may not be appropriate immediately following a myocardial infarction.

Choice E reason: Ambulating four times a day is not recommended immediately following a myocardial infarction as it can increase cardiac workload.

Choice F reason: Maintaining bedrest can help reduce the workload on the heart by minimizing physical activity.

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Correct Answer is C

Explanation

Choice A reason: This response may come off as dismissive and does not address the patient's immediate concerns or feelings.

Choice B reason: While this response offers a solution, it does not engage with the patient's current emotional state or provide immediate support.

Choice C reason: This response is therapeutic as it acknowledges the patient's emotional state and invites them to discuss their concerns, which is important in managing patients with bipolar disorder.

Choice D reason: This response might minimize the patient's feelings and does not encourage communication about the patient's current distress.

A. Notify the patient's family. B. Provide oxygen as prescribed. C. Notify the health care provider. D. Elevate the head of the bed.

Correct Answer is B

Explanation

Choice A Reason:Notifying the patient's family is not the immediate priority when the patient is experiencing severe respiratory distress. The nurse's primary focus should be on addressing the patient's acute symptoms.

Choice B Reason:Providing oxygen is crucial in managing respiratory distress. In a patient with myocardial infarction (heart attack), adequate oxygenation is essential to prevent further complications. The nurse should promptly administer oxygen as prescribed to improve oxygen supply and alleviate distress.

Choice C Reason:While notifying the health care provider is essential, it is not the first action in this critical situation. The nurse should prioritize interventions that directly address the patient's distress.

Choice D Reason:Elevating the head of the bed (semi-Fowler's position) is beneficial for patients with respiratory distress, but it is not the initial action. Providing oxygen takes precedence over positioning.

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The nurse is caring for a male patient, age 54, who had a myocardial infarction 2 days ago. His wife, who is very talkative, has remained at his bedside. Which of these interventions should the nurse implement to reduce the workload of the heart? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on the mental health unit is caring for a client who has bipolar disorder and comes to the nurse's station at 0300 demanding to see the provider. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A patient hospitalized with a myocardial infarction suddenly begins having severe respiratory distress with frothy red sputum. What is the first action for the nurse to take?

Correct Answer is B

Explanation

Your patient with major depressive disorder isolates herself in her room for the whole day. You find her sitting and staring out the window. What is your best therapeutic response when you walk into her room?

Which of the following is not true about depression?

The licensed practical nurse is assisting with collecting data on a female patient. Which of the following findings should be reported to the registered nurse as possible atypical symptoms of a myocardial infarction in the absence of chest pain? Select all that apply.

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The nurse is reinforcing teaching to the patient about the cause of pain from coronary artery disease. The nurse would evaluate the patient as understanding the education if the patient stated which of the following causes the pain from coronary artery disease?

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The nursing interventions for a patient with major depression would include all the following except: