66

Cardiovascular system

2.

lower his heart rate and blood

pressure.
3. lower his blood pressure and
increase his urine output.
4. lower his heart rate and blood
pressure and increase his urine
output.
Answer: 2. Diltiazem, a calcium channel
blocker, will reduce both the heart rate and
blood pressure. It doesnt directly affect urine
output.

NCLEX keys

Pump up on practice
questions
1. A cardiologist prescribes digoxin
(Lanoxin) 125 mcg by mouth every morning
for a client diagnosed with heart failure. The
pharmacy dispenses tablets that contain 0.25
mg each. How many tablets should the nurse
administer in each dose? Record your answer
using one decimal place.
tablet(s)
Answer: 0.5. The nurse should begin by
converting 125 mcg to milligrams.
125 mcg
= 0.125 mg
1,000
The following formula is used to calculate
drug dosages:
Dose on hand
Dose desired
=
Quantity on hand
X
The nurse should use the following equations:
0.25 mg 0.125 mg
=
1 tablet
X
0.25(X) = 0.125
X = 0.5 tablet

Client needs category: Physiological integrity

Client needs subcategory: Pharmacological
and parenteral therapies
Cognitive level: Comprehension
3. A client reports substernal chest pain.
Test results show electrocardiographic
changes and an elevated cardiac troponin
level. What should be the focus of nursing
care?
1. Improving myocardial oxygenation
and reducing cardiac workload
2. Confirming a suspected diagnosis
and preventing complications
3. Reducing anxiety and relieving pain
4. Eliminating stressors and providing a
nondemanding environment
Answer: 1. The client is exhibiting clinical
signs and symptoms of a myocardial infarction (MI); therefore, nursing care should
focus on improving myocardial oxygenation
and reducing cardiac workload. Confirming
the diagnosis of MI and preventing complications, reducing anxiety and relieving pain, and
providing a nondemanding environment are
secondary to improving myocardial oxygenation and reducing workload. Stressors cant
be eliminated, only reduced.

NCLEX keys
Client needs category: Physiological integrity
Client needs subcategory: Pharmacological
and parenteral therapies
Cognitive level: Application
2. A client is prescribed diltiazem
(Cardizem) to manage his hypertension. The
nurse should tell the client the diltiazem will:
1. lower his blood pressure only.

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