Regal films

A 78-year-old client is admitted with a diagnosis of dehydration and change in mental status. He's being hydrated with I.V. fluids. When the nurse takes his vital signs, she notes he has a fever of 103.7° F (39.47° C), a cough producing yellow sputum, and pleuritic chest pain. The nurse suspects this client may have developed:

• acute respiratory distress syndrome (ARDS).

• myocardial infarction (MI).

• pneumonia.

• tuberculosis (TB).

A client with pneumonia develops dyspnea, a respiratory rate of 32 breaths/minute, and difficulty expelling secretions. The nurse auscultates the lung fields and hears bronchial sounds in the left lower lobe. Which action should the nurse take first?

• Administer antibiotics.

• Encourage bed rest.

• Apply oxygen.

• Assess nutritional intake.

A client has been treated with a 10-day course of antibiotic therapy for right lower lobe pneumonia and is scheduled to be discharged today. Select the assessment finding that indicates the client is ready to be discharged.

• Continued dyspnea

• Fever of 102.7° F (38.97° C)

• Respiratory rate of 32 breaths/minute

• Vesicular breath sounds in right base

A client in a long-term care facility has been receiving continuous tube feedings. The nurse notes the client has a cough producing tan sputum and is now febrile to 102.7° F (38.9° C). The nurse auscultates the client's lung fields and hears bronchial breath sounds in the right middle lobe. The nurse suspects the client may have developed:

• atelectasis.

• bronchitis.

• pneumonia.

• pulmonary embolism.

A nurse on a telemetry unit teaches a client diagnosed with acute coronary syndrome about coronary blood flow. Which of the following statements made by the nurse is correct?

• Most of the blood flow to coronary arteries is supplied during inspiration.

• Most of the blood flow to coronary arteries is supplied during diastole.

• Blood flow to coronary arteries is related to breathing patterns.

• A large portion of blood flow occurs to coronary arteries during systole.

A client is admitted to the telemetry floor with acute chest pain radiating down his left arm. The nurse anticipates that which of the following laboratory studies would be ordered to evaluate myocardial damage? Select all that apply.

• Troponin T and troponin I

• Hemoglobin and hematocrit

• Creatinine phosphokinase (CPK)

• Myoglobin

• Serum glucose

A nurse is teaching a client about atherosclerosis. The nurse determines further teaching is necessary when the client makes which of the following statements?

• Plaques obstruct the coronary artery.

• Plaques obstruct the vein.

• Hardened vessels can't dilate to allow blood to flow through.

• Atherosclerosis can cause angina.

The nurse is assessing a client with angina pectoris. Which of the following are characteristics of the substernal chest pain that occurs with this condition? Select all that apply.

• Lasts less than 15 minutes

• Radiates to the left arm

• Is precipitated by exertion or stress

• Is relieved by rest and nitroglycerine

• Occurs without cause

The nurse is reviewing a client's lab work to determine if a risk for coronary artery disease (CAD) is present. The nurse is most concerned when the results identify which of the following?

• HDL= 100 mg/dl

• LDL= 140 mg/dl

• VLDL= 20%

• Total cholesterol = 240 mg/dl

A client is experiencing signs and symptoms of coronary artery disease. What should be the nurse's first priority?

• Decrease anxiety.

• Enhance myocardial oxygenation.

• Administer sublingual nitroglycerin.

• Educate the client about his symptoms.