115-NCLEX-RN Review Made Incredibly Easy, Fifth Edition (Incredibly Easy...

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 keysClient needs category: Physiological integrityClient needs subcategory: Pharmacological and parenteral therapiesCognitive 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 pain4. Eliminating stressors and providing a

nondemanding environmentAnswer: 1. The client is exhibiting clinical signs and symptoms of a myocardial infarc-tion (MI); therefore, nursing care should focus on improving myocardial oxygenation and reducing cardiac workload. Confirming the diagnosis of MI and preventing complica-tions, reducing anxiety and relieving pain, and providing a nondemanding environment are secondary to improving myocardial oxygen-ation and reducing workload. Stressors cant be eliminated, only reduced.

Pump up on practice questions1. 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 mg1,000

The following formula is used to calculate drug dosages:

Dose on hand = Dose desiredQuantity on hand X

The nurse should use the following equations:0.25 mg

= 0.125 mg

1 tablet X0.25(X) = 0.125

X = 0.5 tablet

NCLEX keysClient needs category: Physiological integrityClient needs subcategory: Pharmacological and parenteral therapiesCognitive level: Application

2. A client is prescribed diltiazem (Car dizem) to manage his hypertension. The nurse should tell the client the diltiazem will:

1. lower his blood pressure only.

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