A 58 year old patient is in a cardiac rehabilitation program. The nurse teaches the patient to stop exercising if

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Pain or dyspnea occur. This is the most appropriate response because pain or dyspnea during exercise can indicate a significant issue with the cardiovascular system. It could be a sign of angina, myocardial infarction, or another serious cardiac event that requires immediate attention. Stopping exercise when experiencing these symptoms is crucial for the patient's safety. Option A) The HR exceeds 150 beats per minute is not the best choice because heart rate can vary greatly depending on the individual's fitness level. While exceeding 150 bpm may be a concern for some, it is not a definitive indicator to stop exercise for all patients. Option C) The respiratory rate increases to 30 breaths per minute is also not as critical as option B. An increased respiratory rate could be due to factors other than cardiac issues, such as poor fitness level or environmental conditions. Option D) The HR is 15 beats over the resting heart rate is a vague and arbitrary measure. It does not account for individual variability in heart rate response to exercise and may not accurately reflect the patient's physiological limits. In an educational context, it is important to teach patients in cardiac rehabilitation programs about the signs and symptoms that warrant stopping exercise. Understanding these warning signs can help prevent serious complications and promote safe participation in physical activity. Encouraging patients to listen to their bodies and seek medical attention if they experience pain or difficulty breathing during exercise is essential for their well-being.

Correct Answer: A

Rationale: In this scenario, the best patient to assign to the new graduate RN is option A, the 19-year-old with rheumatic fever who needs discharge teaching. This patient is stable, requiring education on self-care and transitioning home, which aligns with the new graduate's skill set and the focus of their orientation program. By providing discharge instructions, the new nurse can reinforce their learning and develop their patient teaching skills. Option B, the 33-year-old with endocarditis receiving IV ceftizoxime, is not ideal for the new graduate as it involves administering a high-risk medication that requires advanced knowledge and experience. Option C, the 50-year-old with stable angina, although stable, has complex medication and care needs that may overwhelm a new graduate. Option D, the 75-year-old post-coronary artery bypass grafting, is also not suitable due to the recent surgery and potential for post-operative complications that require a higher level of expertise. Educationally, assigning appropriate patient assignments is crucial for new graduates to build confidence, competence, and critical thinking skills. By matching patient acuity and complexity with the nurse's level of experience, we support their professional growth and ensure safe and effective care delivery.

Correct Answer: B

Rationale: Rationale: The correct answer is B) It may indicate an allergy to iodine. When assessing a client with a cardiovascular disorder for seafood allergy, the nurse is primarily concerned about the potential cross-reactivity between seafood and iodine. Iodine is a component found in some contrast dyes used in cardiovascular diagnostic procedures like angiography. Individuals allergic to seafood, particularly shellfish, may also have an allergic reaction to iodine. This information is crucial for the nurse to prevent adverse reactions during diagnostic tests involving iodine-based contrast agents. Option A) It can contribute to cardiac symptoms is incorrect because a seafood allergy, in itself, does not directly contribute to cardiac symptoms unless an allergic reaction occurs due to iodine exposure during diagnostic procedures. Option C) It can contribute to drug interactions is incorrect as assessing seafood allergy is more related to iodine exposure during diagnostic tests rather than drug interactions in the context of cardiovascular disorders. Option D) It indicates a genetic predisposition to cardiac disorders is incorrect as a seafood allergy does not inherently suggest a genetic predisposition to cardiac disorders. Allergic reactions to iodine in seafood-allergic individuals are a specific concern in the cardiovascular setting. Educational Context: Understanding the importance of assessing for seafood allergy in cardiovascular patients is vital for nurses working in various healthcare settings. This knowledge ensures patient safety during diagnostic procedures involving iodine-based contrast media. Nurses need to be aware of potential cross-reactivity between seafood and iodine to prevent adverse reactions and provide optimal care for patients with cardiovascular disorders.

Correct Answer: D

Rationale: In the case of mitral valve stenosis, an early indication is dyspnea, which is difficulty or discomfort in breathing. This occurs because the narrowing of the valve impedes blood flow from the left atrium to the left ventricle, leading to increased pressure in the lungs and ultimately causing shortness of breath. A) Changes in heart sounds are more commonly associated with conditions like murmurs or valve regurgitation rather than stenosis of the mitral valve. While auscultation is important in diagnosing heart conditions, it is not typically an early sign of mitral valve stenosis. B) Crackles in the bases of the lungs are typically associated with conditions like heart failure or pneumonia, which can be consequences of untreated mitral valve stenosis but are not early indicators of the valve stenosis itself. C) Heart palpitations, or rapid, irregular heartbeats, are more commonly associated with conditions like atrial fibrillation or palpitations related to anxiety or stress. While palpitations can occur in patients with mitral valve stenosis due to associated arrhythmias, they are not specific early indicators of the valve stenosis itself. Educational Context: Understanding the early signs of mitral valve stenosis is crucial for healthcare providers to prompt early intervention and prevent complications. Dyspnea in this context serves as a red flag for further investigation and diagnostic testing to confirm the presence of mitral valve stenosis. Healthcare professionals need to be able to differentiate between various symptoms to provide accurate and timely care for patients with cardiovascular conditions.

Correct Answer: C

Rationale: The correct answer is C) Percutaneous transluminal coronary angioplasty (PTCA). In PTCA, a balloon-tipped catheter is used to compress the atherosclerotic plaque against the arterial wall, widening the diameter of the artery. This procedure helps to improve blood flow through the diseased coronary artery, relieving symptoms of angina and reducing the risk of a heart attack. Option A) Coronary stent is incorrect because a stent is a mesh-like tube inserted into the artery after angioplasty to help keep it open. It is not the initial procedure described in the question. Option B) Atherectomy involves removing plaque from the artery using a cutting device. This is different from the balloon angioplasty described in the question. Option D) Coronary artery bypass grafting (CABG) is a surgical procedure where blood flow is rerouted around blocked arteries using grafts. It is not the same as the minimally invasive PTCA procedure described. Understanding these distinctions is crucial for healthcare professionals working in cardiology to determine the most appropriate intervention for patients with coronary artery disease. PTCA is a common and effective procedure used to treat coronary artery blockages and is often performed in a cardiac catheterization lab by interventional cardiologists.