A patient received an implantable cardioverter-defibrillator (ICD). The nurse includes what instruction during discharge teaching for this patient?
1. If a family member is in direct contact with you when the ICD discharges, he or she may experience a shock or tingling sensation.
2. You can activate the ICD whenever you feel a change in your heart rhythm.
3. The batteries of the ICD won't need to be replaced if the ICD never shocks the heart.
4. There should be no discomfort if the ICD discharges, and you probably won't notice it.
Question 2A nurse is preparing a presentation on coronary heart disease (CHD) for a community women's club. Which statements should the nurse include in the presentation?
Select all that apply.
1. The epigastric pain and nausea experienced with a heart attack are often attributed to heartburn.
2. Common symptoms of myocardial infarction (MI) include shortness of breath and fatigue.
3. Women are more likely to have an unrecognized myocardial infarction.
4. Weakness of the legs and back often precede a heart attack.
5. The mortality rate of young women having an MI is 50 lower than that of men.
Question 3The patient has a pacemaker with one pacing spike seen on the ECG before every QRS complex. There is no change in the pacemaker rhythm over time, with rest or with activity. The nurse realizes the patient has what type of pacemaker?
1. asynchronous pacing
2. demand pacing
3. dual-chamber pacing
4. atrial single-chamber pacing
Question 4A patient is in sinus tachycardia. Which nursing interventions are appropriate?
Select all that apply.
1. Observe the patient for effects on cardiac function.
2. Administer two tablets of acetaminophen (Tylenol) per physician prescription if an elevated temperature is present.
3. Administer normal saline 0.9 IV at the prescribed rate of 200 mL per hour if hypovolemia is suspected as the cause.
4. Give pain medications as prescribed if pain is present.
5. Give atropine per physician prescription to slow the heart rate.
Question 5The nurse is notified by the cardiac monitoring technician that a patient on continuous cardiac monitoring is having frequent alarms. When the nurse enters the patient's room, the patient is in no apparent distress, is sitting in the chair and eating.
Which are appropriate nursing interventions?
Select all that apply.
1. Confirm that lead wires are properly connected.
2. Assess placement of electrodes.
3. Remove and reapply new electrodes if nonadherent.
4. Assess skin sites and move an electrode if the skin appears irritated.
5. Call for assistance.
Question 6The nurse is instructing a patient on nitroglycerin tablets prescribed to treat angina. Which statement(s) should be included in the nurse's instructions?
Select all that apply.
1. Take a second dose if the angina is not relieved within five minutes.
2. The drug should remain in this brown bottle since it is sensitive to light.
3. Store this medication in your bathroom medicine cabinet so it is readily available to you.
4. Eating or drinking will not interfere when taking the medication.
5. Call your doctor immediately if you develop a headache when taking this drug.
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