For Mr. Cook, initially found with high blood pressure, the most appropriate nursing action would be

Correct Answer: A

Rationale: The correct answer is option A) Take his blood pressure in his right arm while he is sitting and resting. This is the most appropriate nursing action because measuring blood pressure in a standardized and consistent manner is crucial for accurate assessment. Taking the blood pressure in a specific arm while the patient is sitting and at rest allows for a reliable baseline measurement. This is important for monitoring trends and making informed decisions about treatment. Option B is incorrect because it is not the nurse's role to diagnose or prescribe medication. It is essential to follow proper protocols and consult with a healthcare provider for diagnosis and treatment decisions. Option C is also incorrect as immediate referral to a physician may not be necessary based solely on one high blood pressure reading. Nurses play a critical role in initial assessment and monitoring before escalating care. Option D is incorrect because it is not appropriate to reassure a patient that elevated blood pressure is normal. It is essential to address high blood pressure with further assessment and potential interventions to prevent complications. In an educational context, understanding the correct procedure for measuring blood pressure and the role of the nurse in initial assessment is fundamental for nursing practice. This question highlights the importance of accurate assessment and appropriate nursing actions in managing patients with high blood pressure.

Correct Answer: B

Rationale: The correct answer is B) Walking or bicycling 20 minutes at least three times a week. After an inferior-wall myocardial infarction, also known as a heart attack, it is crucial for Mr. Bradley to engage in a regular aerobic exercise program to improve his cardiovascular health. Walking or bicycling at least three times a week for 20 minutes helps in improving cardiovascular fitness, strengthening the heart, and enhancing overall well-being without putting excessive strain on the heart. Option A) Golf or bowling two or three times a week may not provide a consistent level of aerobic exercise required for cardiovascular benefits. These activities are not as effective in improving cardiovascular fitness as sustained aerobic exercises like walking or cycling. Option C) Running the quarter mile daily may be too strenuous for someone recovering from a heart attack, especially if they are just starting an exercise program. High-intensity exercises like running may put excessive strain on the heart and lead to complications. Option D) Lifting weights daily is more focused on strength training rather than cardiovascular fitness. While strength training is beneficial, especially when supervised and tailored to the individual, aerobic exercise is more critical initially for cardiovascular recovery. In an educational context, it is essential for healthcare providers to educate patients on the appropriate type and intensity of exercise post-myocardial infarction. Emphasizing the importance of aerobic exercises like walking or cycling can help patients like Mr. Bradley improve their heart health, reduce the risk of future cardiac events, and enhance their overall quality of life. Monitoring and gradually increasing the intensity of exercise under medical supervision is key to a safe and effective recovery.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: Bolus IV followed by lidocaine drip at 2 mg/min. This treatment approach is appropriate for Mr. Murphy's situation because lidocaine is a class IB antiarrhythmic medication commonly used to treat ventricular arrhythmias. Administering a bolus intravenous (IV) dose followed by a maintenance drip helps rapidly achieve therapeutic levels to stabilize the arrhythmia. Option A is incorrect because giving GM 7-p.o. (presumably glucose monitoring) is not a treatment for arrhythmias. Option C is incorrect as repeatedly administering bolus doses every 5 minutes is not the standard protocol for lidocaine administration and may lead to toxicity. Option D is also incorrect as administering a continuous IV drip at 1 mg/min is insufficient to rapidly manage a ventricular arrhythmia. Educationally, understanding the appropriate administration of antiarrhythmic medications is crucial for nurses caring for patients with cardiovascular issues. Recognizing the urgency of arrhythmias and knowing the correct dosing and administration routes can be life-saving. It is important to be familiar with the pharmacological actions of medications like lidocaine to provide safe and effective care to patients in acute situations.

Correct Answer: A

Rationale: The correct answer is A) Has tolerated the procedure well. Following aortic valve replacement surgery, it is common for patients to experience increased heart rate, respiratory rate, and coughing up white sputum due to the body's response to the surgical trauma and anesthesia. Pain may be managed well by medications given during and after the surgery. These signs are expected in the immediate postoperative period and do not necessarily indicate a complication. It is important for healthcare providers to recognize normal postoperative findings to differentiate them from signs of complications. Option B) Needs to see a physician immediately is incorrect because the symptoms described are typical in the early postoperative period and do not indicate an emergent situation requiring immediate attention. Option C) Needs to be given a nitroglycerin tablet is incorrect because nitroglycerin is primarily used to manage chest pain related to cardiac ischemia, which is not the presenting issue in this scenario. Option D) Is going into shock is incorrect as the symptoms described do not align with the classic signs of shock, such as hypotension, altered mental status, and poor peripheral perfusion. In an educational context, it is crucial for healthcare professionals to understand the expected postoperative course following cardiac surgery to provide appropriate care and prevent unnecessary interventions or alarm. Recognizing normal variations from potential complications is key in delivering safe and effective patient care.