In an assessment for intermittent claudication, the cardiac-vascular nurse assesses for leg pain and cramping with exertion, then asks the patient:

Correct Answer: C

Rationale: In assessing for intermittent claudication, the correct answer is C) Is the leg pain relieved by rest? This is because intermittent claudication is characterized by leg pain or cramping that occurs with activity and is relieved by rest. The pain is typically due to decreased blood flow to the muscles during exertion. Rest allows for the oxygen demand of the muscles to decrease, relieving the pain. Option A) Does shortness of breath accompany the leg pain? is incorrect because shortness of breath is more indicative of a cardiac or pulmonary issue rather than intermittent claudication, which is specifically related to blood flow to the legs during activity. Option B) Does this same type of pain occur without activity? is incorrect as intermittent claudication is specifically associated with pain during activity due to inadequate blood flow, not at rest. Option D) Is the leg pain relieved with elevation? is incorrect because elevation typically worsens symptoms of intermittent claudication by decreasing blood flow further to the affected area. Educationally, understanding the specific characteristics of intermittent claudication is crucial for healthcare providers, especially nurses, in accurately assessing and managing patients with peripheral arterial disease. Recognizing the pattern of pain associated with intermittent claudication can help in differentiating it from other causes of leg pain and guide appropriate interventions to improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, patient D should be taught first about preventing coronary artery disease (CAD) because they are at the greatest risk based on their lipid profile results. Patient D has a total cholesterol of 250 mg/dL, triglycerides of 164 mg/dL, LDL of 172 mg/dL, and HDL of 32 mg/dL, which indicate elevated levels of LDL (bad cholesterol) and triglycerides, and low levels of HDL (good cholesterol), all of which are significant risk factors for CAD. Patients A, B, and C have more favorable lipid profiles compared to patient D. While patient C has higher total cholesterol and LDL levels, their HDL level is higher compared to patient D. Patients A and B have even better lipid profiles with lower total cholesterol, LDL, and triglycerides, and higher HDL levels compared to patient D. In an educational context, it is crucial for nurses to understand how to interpret lipid profile results and identify patients at higher risk for CAD. Teaching patients about lifestyle modifications, such as healthy diet, regular exercise, smoking cessation, and medication adherence, is essential in preventing CAD. Patient D requires immediate education and intervention to address their elevated risk factors and reduce the likelihood of developing CAD.

Correct Answer: B

Rationale: The correct answer is B) Heart failure. When crackles in the lungs and an S3 heart sound are present during a cardiovascular assessment post-MI, it indicates the development of heart failure. Crackles suggest fluid buildup in the lungs due to impaired cardiac function, which is a hallmark of heart failure. The S3 heart sound, also known as a ventricular gallop, is often heard in heart failure as the ventricles fill with blood during diastole. Option A) Pericarditis is incorrect because it typically presents with chest pain that worsens with breathing and changes in body position. It is characterized by a pericardial friction rub, not crackles in the lungs. Option C) Ventricular aneurysm usually presents with persistent ST-segment elevation on an ECG post-MI and may lead to arrhythmias or heart failure but does not directly cause crackles in the lungs. Option D) Papillary muscle dysfunction can lead to mitral regurgitation, which can present with a murmur, but not crackles in the lungs or an S3 heart sound. Educationally, understanding these clinical manifestations post-MI is crucial for nurses to provide timely and appropriate interventions to prevent further complications and improve patient outcomes. Recognizing the significance of crackles and S3 heart sound in this context helps nurses prioritize care and collaborate with the healthcare team for comprehensive management of post-MI complications.

Correct Answer: C

Rationale: In advising a male patient who has had a myocardial infarction (MI) about sexual activity, the nurse should recommend option C) Prophylactic nitroglycerin may be used if angina occurs. This is the correct answer because nitroglycerin is a vasodilator that helps to relax and widen blood vessels, increasing blood flow to the heart muscle. If the patient experiences angina, which can be triggered by physical exertion like sexual activity, nitroglycerin can help relieve chest pain by improving blood supply to the heart. Option A) The patient should use the superior position is incorrect because there is no evidence to support the superiority of this position in reducing the risk of complications during sexual activity after an MI. Option B) Foreplay may cause too great an increase in heart rate is incorrect as moderate physical activity, including foreplay, is generally considered safe for most patients with stable cardiovascular conditions. Option D) Performance can be enhanced with the use of sildenafil (Viagra) is also incorrect. While sildenafil is a medication commonly used to treat erectile dysfunction, it is not recommended for patients with recent myocardial infarction or those who are taking nitrates like nitroglycerin due to the risk of a dangerous drop in blood pressure. Educational context: It is crucial for healthcare providers to address sexual activity concerns with patients who have had a myocardial infarction. Providing accurate information and guidance can help alleviate anxiety and ensure the patient's safety. Educating patients about using nitroglycerin prophylactically if angina occurs during sexual activity empowers them to manage their condition effectively and engage in a healthy and satisfying sex life while prioritizing their cardiovascular health.

Correct Answer: C

Rationale: The correct answer is C) Both A and B: Data collection and interpretation are both crucial aspects of the nurse's role in hemodynamic monitoring. Data collection involves gathering vital signs, cardiac output measurements, blood pressure readings, and other relevant information to assess the patient's cardiovascular status. Nurses must accurately collect this data to provide a comprehensive picture of the patient's hemodynamic stability. Interpretation involves analyzing the collected data to identify trends, abnormalities, and potential complications. Nurses need to have a deep understanding of normal hemodynamic parameters and be able to recognize deviations that may indicate deteriorating cardiac function or other issues requiring intervention. Option A) Data collection alone is not sufficient as without the ability to interpret the data, the information gathered may not be used effectively to guide patient care. Option B) Interpretation alone is also inadequate because without accurate data collection, nurses cannot make informed decisions based on incomplete or inaccurate information. Option D) None of the above is incorrect because both data collection and interpretation are essential components of the nurse's role in hemodynamic monitoring. In an educational context, understanding the nurse's role in hemodynamic monitoring is vital for providing safe and effective patient care, especially in critical care settings where hemodynamic instability can have serious consequences. Nurses must be competent in both data collection and interpretation to assess and intervene promptly in response to changes in a patient's cardiovascular status.