Tricky homework questions - HELP!

Nurses General Nursing

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Can someone please help me on these homework questions, I just don't know the answers and can't find them in my text book.

1) Which of the following statements by a client diagnosed with hypertension indicates a need for additional teaching?

1. "All of the medications have lots of side effects"

2. "Exercise helps to control the disease"

3. "I need to eat meals that have less salt and fat"

4. "My blood pressure is lower when I'm at home"

2) A patient is admitted to the emergency department for chest pain. His ECG findings show ST elevations indicating acute myocardial infarction. The ER doctor orders standard cardiac therapy including aspirin and metoprolol and then asks you to complete a bleeding history and contact the patient's primary-care physician. The primary physician gives you standard orders for oxygen therapy, nitroglycerine and heparin. He then asks that the patient's labs to be called to him for further orders. Before hanging up the phone, you should say:

1. "Considering the positive ECG, don't you want to order a thrombolytic?"

2. "He is quite uncomfortable, what would you like me to give him for pain?"

3. "Thank you, I will get back to you as soon as I have lab confirmation"

4. "Would you like me to go ahead and arrange for transfer to the CCU?"

3) What heart sound is classic for congestive heart failure?

1. diastolic murmur

2. pericardial rub

3. S3 gallop

4. S4 gallop

4) The nurse finds the client to be in ventricular tachycardia and pulseless. What is the nurse's best first action?

1. Administer an anti-dysrhythmic medication

2. Administer oxygen

3. Initiate CPR

4. Instruct the client to take deep breaths and cough

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

I'll take a stab at these, hope it's not too late to help.

1. One and Four raise red flags w/me, especially answer Four. This pt may not understand the importance of taking the BP meds AS PRESCRIBED; the comment about the BP being lower at home tends to suggest the pt doesn't understand the workings of BP. If the BP trend is hypertension, the meds need to be taken, and this needs to be reinforced.

2. Personally I would word any of these answers quite differently. That said, I'd go with 2. 2. supports standard ACLS algorithm for ACS: MONA. The O2, NTG and ASA have been ordered, but not the Morphine.

3. I knew this one, but googled it to be sure (used "heart sound CHF" to search): an S3 will be heard.

4. Google the ACLS algorithm for Pulseless VT. If the nurse knows it's VT, I have to assume the pt is monitored! Doesn't say if the pt is unresponsive, either. In any case, with pulselessness, initiate CPR.

I'm always open to learn from other nurses, so if anyone has different impressions, I'd be interested to see them.

I do hope you got your answers LONG before my post, by using google or yahoo search engines. Good luck! -- D

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Thanks for trying to help with these tough questions!

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!) is one--The wording "all" and "lots" is the clue

2) is three--you are letting the dr know you understand you are to report back with the lab results. ER dr will deal with the pain issue

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Can someone please help me on these homework questions, I just don't know the answers and can't find them in my text book.

1) Which of the following statements by a client diagnosed with hypertension indicates a need for additional teaching?

1. "All of the medications have lots of side effects"

2. "Exercise helps to control the disease"

3. "I need to eat meals that have less salt and fat"

4. "My blood pressure is lower when I'm at home"

1 sounds like a possibility, but 2 to me is an equal possibility...HTN isn't a disease, it's a symptom of something bigger.

2) A patient is admitted to the emergency department for chest pain. His ECG findings show ST elevations indicating acute myocardial infarction. The ER doctor orders standard cardiac therapy including aspirin and metoprolol and then asks you to complete a bleeding history and contact the patient's primary-care physician. The primary physician gives you standard orders for oxygen therapy, nitroglycerine and heparin. He then asks that the patient's labs to be called to him for further orders. Before hanging up the phone, you should say:

1. "Considering the positive ECG, don't you want to order a thrombolytic?"

2. "He is quite uncomfortable, what would you like me to give him for pain?"

3. "Thank you, I will get back to you as soon as I have lab confirmation"

4. "Would you like me to go ahead and arrange for transfer to the CCU?"

2 would be my choice; of course 3 is reasonable, but it's surely not the answer they're looking for

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Specializes in PeriOp, ICU, PICU, NICU.
Can someone please help me on these homework questions, I just don't know the answers and can't find them in my text book.

1) Which of the following statements by a client diagnosed with hypertension indicates a need for additional teaching?

1. "All of the medications have lots of side effects"

2. "Exercise helps to control the disease"

3. "I need to eat meals that have less salt and fat"

4. "My blood pressure is lower when I'm at home"

I AM GOING TO GUESS #2 BECAUSE EXCERSICE IS PART OF THE PLAN BUT WILL ONLY WORK ALONG WITH PROPER DIET,EXCERSICE AND STRESS. THE NURSE WOULD PROBABLY HAVE TO REINFORCE THAT. I AM NOT PUTTING MY MONEY ON IT, BUT I WOULD HAVE PICKED THAT ONE. GOOD LUCK AND POST THE ANSWERS WHEN YOU GET THEM :)

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can someone please help me on these homework questions, i just don't know the answers and can't find them in my text book.

1) which of the following statements by a client diagnosed with hypertension indicates a need for additional teaching?

1. "all of the medications have lots of side effects"

2. "exercise helps to control the disease"

3. "i need to eat meals that have less salt and fat"

4. "my blood pressure is lower when i'm at home"

#4. this is the kind of statement i have heard when pts are attempting to deny the problem. more teaching is needed!"

2) a patient is admitted to the emergency department for chest pain. his ecg findings show st elevations indicating acute myocardial infarction. the er doctor orders standard cardiac therapy including aspirin and metoprolol and then asks you to complete a bleeding history and contact the patient's primary-care physician. the primary physician gives you standard orders for oxygen therapy, nitroglycerine and heparin. he then asks that the patient's labs to be called to him for further orders. before hanging up the phone, you should say:

1. "considering the positive ecg, don't you want to order a thrombolytic?"

2. "he is quite uncomfortable, what would you like me to give him for pain?"

3. "thank you, i will get back to you as soon as i have lab confirmation"

4. "would you like me to go ahead and arrange for transfer to the ccu?"

#2. get pain med.

3) what heart sound is classic for congestive heart failure?

1. diastolic murmur

2. pericardial rub

3. s3 gallop

4. s4 gallop

#3. had to look this one up. (hey, i'm an ortho nurse!)

4) the nurse finds the client to be in ventricular tachycardia and pulseless. what is the nurse's best first action?

1. administer an anti-dysrhythmic medication

2. administer oxygen

3. initiate cpr

4. instruct the client to take deep breaths and cough

#3. no pulse... lets get moving!

.

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Specializes in Geriatrics, Pediatrics, Home Health.

OK I have a question....How can he be in V Tach and be pulseless!?!?!?!?!?!

Also, wouldn't you put him on O2 first. ABC's then start CPR?

Thanks!!

________________________________________________________

In His Grace,

Karen

Failure is NOT an option!!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
OK I have a question....How can he be in V Tach and be pulseless!?!?!?!?!?!

Also, wouldn't you put him on O2 first. ABC's then start CPR?

Thanks!!

________________________________________________________

In His Grace,

Karen

Failure is NOT an option!!

.....was wondering that myself, but being on my first cuppa joe, thought maybe I was just reading it wrong.

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Specializes in NICU.
Can someone please help me on these homework questions, I just don't know the answers and can't find them in my text book.

1) Which of the following statements by a client diagnosed with hypertension indicates a need for additional teaching?

1. "All of the medications have lots of side effects"

2. "Exercise helps to control the disease"

3. "I need to eat meals that have less salt and fat"

4. "My blood pressure is lower when I'm at home"

2) A patient is admitted to the emergency department for chest pain. His ECG findings show ST elevations indicating acute myocardial infarction. The ER doctor orders standard cardiac therapy including aspirin and metoprolol and then asks you to complete a bleeding history and contact the patient's primary-care physician. The primary physician gives you standard orders for oxygen therapy, nitroglycerine and heparin. He then asks that the patient's labs to be called to him for further orders. Before hanging up the phone, you should say:

1. "Considering the positive ECG, don't you want to order a thrombolytic?"

2. "He is quite uncomfortable, what would you like me to give him for pain?"

3. "Thank you, I will get back to you as soon as I have lab confirmation"

4. "Would you like me to go ahead and arrange for transfer to the CCU?"

3) What heart sound is classic for congestive heart failure?

1. diastolic murmur

2. pericardial rub

3. S3 gallop

4. S4 gallop

4) The nurse finds the client to be in ventricular tachycardia and pulseless. What is the nurse's best first action?

1. Administer an anti-dysrhythmic medication

2. Administer oxygen

3. Initiate CPR

4. Instruct the client to take deep breaths and cough

That totally made me laugh. It brought back memories of my R.N. exams 16 years ago. Those questions can be quite tricky. Thanks goodness in real life, you are dealling with the patient, lab results and ultimately help from the other medical team members!

My answers would be :

1) #1 as those little words "all" and "lots" are usually clues in multiple choice questions. (The pt's statement about realizing his B.P. is lower at home is great, as long as he doesn't omit his meds because of this! This, to me tells me he is at least monitoring his B.P!)

2) #3 tells me that you're following the doctor's orders and perhaps the ordered drugs will help relive his pain(?) (I'm not familiar with the routine of the E.R but if he sticks around awaiting a bed in I.C.U..he'll need his pain relieved if he's still experiencing pain!)

3) no idea!

4) well, if he's pulseless, there's no question: start C.P.R. although I was confused a tad..I guess tachycardia doesn't suggest a pulse??

Good luck....

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OK I have a question....How can he be in V Tach and be pulseless!?!?!?!?!?!

Also, wouldn't you put him on O2 first. ABC's then start CPR?

Thanks

________________________________________________________

In His Grace,

Karen

Failure is NOT an option!!

PEA= pulseless electrical activity. start CPR. electrical conduction is happening, but no mechanical response. you have to pump the heart for them. this is a code. no pulse. bag them till code team arrives to intubate. 02 per nasal cannula will do no good.

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Specializes in Critical Care/ICU.
How can he be in V Tach and be pulseless!?!?!?!?!?!

If a person is tamponading. There would be so much fluid around the heart, the heart would not be able to fill enough to pump out an adequate stroke volume. So it beats faster and faster to pump out what little it can. Largely decreased or next to no stroke volume = no pulse.

Also, wouldn't you put him on O2 first. ABC's then start CPR?

What good would 02 do if the patient's not breathing?

Think Basic Life Support.

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