The client, returning from a coronary catheterization in which the femoral artery approach was used, sneezes. Which should be the nurse's priority intervention?

Correct Answer: D

Rationale: The correct answer is D: Check the insertion site. This is the priority intervention because sneezing can increase pressure in the femoral artery, potentially causing bleeding or dislodging the catheter. Checking the insertion site allows the nurse to assess for any signs of bleeding, hematoma, or catheter migration. Palpating pedal pulses (choice A) may be important but not as immediate as ensuring catheter site integrity. Measuring vital signs (choice B) is important but not the priority in this scenario. Assessing for urticaria (choice C) is not relevant to the immediate risk associated with sneezing post-catheterization.

Correct Answer: D

Rationale: The correct answer is D because beta blockers lower heart rate by blocking the effects of adrenaline on the heart. This results in a decreased pulse rate. Choice A is incorrect because beta blockers typically lower blood pressure. Choice B is incorrect as beta blockers do not directly affect respiratory rate. Choice C is incorrect because beta blockers do not affect oxygen saturation directly. Overall, the expected assessment after administering a beta blocker would be a decrease in heart rate (pulse).

Correct Answer: B

Rationale: The correct answer is B: Hyperinflation of lungs documented by chest x-ray. In COPD exacerbation, the airways become inflamed and narrowed, leading to air trapping and hyperinflation of the lungs. This is evidenced on chest x-ray by increased lung volume and flattened diaphragms due to overinflation. Choices A, C, and D are incorrect because in COPD exacerbation, oxygen saturation typically decreases with ambulation due to impaired gas exchange, a widened diaphragm is not a typical finding on chest x-ray in COPD exacerbation, and a shortened expiratory phase is more commonly seen in obstructive lung diseases like asthma rather than COPD exacerbation.

Correct Answer: A

Rationale: The correct answer is A: Angiotension converting enzyme (ACE) inhibitors. Post-myocardial infarction, ACE inhibitors are crucial in managing heart failure by reducing afterload, improving cardiac function, and preventing adverse remodeling. ACE inhibitors also decrease mortality rates in patients with heart failure. Beta blockers (B) are also important but are typically initiated later in the treatment plan. Calcium channel blockers (C) are not first-line agents in heart failure treatment. Diuretics (D) are used to manage fluid overload but are not specifically indicated for post-myocardial infarction heart failure management.

Correct Answer: B

Rationale: The correct answer is B: conducting health assessments. Nurses in physician offices play a crucial role in assessing patients' health status, collecting vital signs, conducting physical exams, and gathering medical history. This responsibility enables them to provide essential information to the physician for diagnosis and treatment planning. Prescribing medications (choice A) is typically the responsibility of physicians, not nurses. Performing minor surgery (choice C) requires specialized training and usually falls under the scope of practice of surgeons or other healthcare providers. Making independent home visits (choice D) may not be a typical responsibility of nurses in physician offices, as their primary role is to assist with patient care within the office setting.