The nurse instructs a client diagnosed with hypertension and coronary artery disease who has been given a new prescription for carvedilol 6.25 mg PO bid to:

Increase the intake of dietary fiber

Change from a lying to sitting position slowly

Expect weight gain of 6-8 pounds

Take the medication after eating breakfast

Answer and Explanation

The Correct Answer is B

Choice A reason: Increasing the intake of dietary fiber is not related to the instruction for carvedilol. Dietary fiber is beneficial for lowering cholesterol and blood sugar levels, but it does not affect the action or side effects of carvedilol. The client should follow a balanced diet that is low in sodium, fat, and cholesterol.

Choice B reason: This is the correct answer. Changing from a lying to sitting position slowly is an important instruction for carvedilol. Carvedilol is a beta-blocker that lowers the blood pressure and the heart rate. It can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can lead to dizziness, fainting, or falls. The client should change positions gradually and avoid sudden movements.

Choice C reason: Expecting weight gain of 6-8 pounds is not an instruction for carvedilol. Weight gain is not a common or expected side effect of carvedilol. It can indicate fluid retention, which can worsen the heart condition and the blood pressure. The client should monitor their weight regularly and report any significant changes to the health care provider.

Choice D reason: Taking the medication after eating breakfast is not an instruction for carvedilol. Carvedilol can be taken with or without food, depending on the client's preference and tolerance. The important thing is to take the medication at the same time every day and not to skip or double the doses.

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Correct Answer is D

Explanation

Choice A reason: This is not a correct interpretation. An occlusion of the right coronary artery is a blockage of the blood flow to the right side of the heart, which can cause a heart attack or ischemia. This condition does not produce a systolic murmur, but rather chest pain, shortness of breath, sweating, or nausea. A systolic murmur is a sound that occurs during the contraction of the heart, when the blood flows through a narrowed or leaky valve.

Choice B reason: This is not a correct interpretation. An aneurysm of the descending aorta is a bulging or weakening of the wall of the large artery that carries blood from the heart to the lower body. This condition does not produce a systolic murmur, but rather a pulsating mass in the abdomen, back pain, or abdominal pain. A systolic murmur is a sound that occurs during the contraction of the heart, when the blood flows through a narrowed or leaky valve.

Choice C reason: This is not a correct interpretation. Decreased fluid in the pericardial sac is a condition where the amount of fluid that surrounds and cushions the heart is reduced. This can be caused by dehydration, infection, or inflammation. This condition does not produce a systolic murmur, but rather a pericardial friction rub, which is a scratching or grating sound that occurs when the layers of the pericardium rub against each other. A systolic murmur is a sound that occurs during the contraction of the heart, when the blood flows through a narrowed or leaky valve.

Choice D reason: This is the correct interpretation. Distortion of one or more heart valves is a condition where the shape or function of the valves that regulate the blood flow through the heart is altered. This can be caused by congenital defects, rheumatic fever, endocarditis, or aging. This condition can produce a systolic murmur, which is a sound that occurs during the contraction of the heart, when the blood flows through a narrowed or leaky valve. The location and the intensity of the murmur can help identify which valve is affected. A systolic murmur in the second intercostal space to the right of the sternum can indicate a problem with the aortic valve.

A. Has gained 2 pounds and has pink buccal mucosa B. No longer has paresthesia of the hands and feet C. Realizes eating more iron fortified cereals D. Has stopped drinking any alcoholic beverages

Correct Answer is B

Explanation

Choice A reason: While gaining weight and having pink buccal mucosa can be signs of overall improved health, they are not specific indicators of effective treatment for vitamin B12 deficiency¹².

Choice B reason: Paresthesia (a sensation of tingling, tickling, pricking, or burning of a person's skin) of the hands and feet is a common symptom of vitamin B12 deficiency¹². If the client no longer has this symptom, it could indicate that the treatment for vitamin B12 deficiency has been effective¹².

Choice C reason: Eating more iron-fortified cereals can contribute to overall nutritional health, but it's not directly related to the treatment of vitamin B12 deficiency¹².

Choice D reason: While stopping alcohol consumption can improve overall health, it's not a specific indicator of effective treatment for vitamin B12 deficiency¹²..

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The nurse instructs a client diagnosed with hypertension and coronary artery disease who has been given a new prescription for carvedilol 6.25 mg PO bid to:

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Naxlex Comprehensive Predictor Exams

The nurse auscultates a systolic murmur in the second intercostal space to the right of the sternum while performing a cardiac assessment on a client. The nurse interprets this finding as:

Correct Answer is D

Explanation

The client diagnosed with vitamin B12 deficiency presents to the outpatient department for the follow-up evaluation. Which nursing assessment finding indicates that the treatment has been effective? The client:

Correct Answer is B

Explanation

The nurse is reviewing the past medical history of a group of clients. Which client would the nurse suspect as having folic acid deficiency? The:

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