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NCLEX keys
Client needs category: Physiological integrity
Client needs subcategory: Reduction of risk
potential
Cognitive level: Analysis
4. A client with a myocardial infarction and
cardiogenic shock is placed on an intra-aortic
balloon pump (IAPB). If the device is functioning properly, the balloon inflates when
the:
1. tricuspid valve is closed.
2. pulmonic valve is open.
3. aortic valve is closed.
4. mitral valve is closed.
Answer: 3. An IAPB inflates during diastole
when the tricuspid and mitral valves are open
and the aortic and pulmonic valves are closed.

NCLEX keys
Client needs category: Physiological integrity
Client needs subcategory: Physiological
adaptation
Cognitive level: Comprehension
5. A client with unstable angina receives
routine applications of nitroglycerin ointment.
The nurse should delay the next dose if the
client has:
1. atrial fibrillation.
2. a systolic blood pressure below
90 mm Hg.
3. a headache.
4. skin redness at the current site.
Answer: 2. Nitroglycerin is a vasodilator and
can lower arterial blood pressure. As a rule,

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when the clients systolic blood pressure is


below 90 mm Hg, the nurse should delay the
dose and notify the physician. Nitroglycerin
isnt contraindicated in a client with atrial
fibrillation. Headache, a common occurrence with nitroglycerin isnt a cause for
withholding a dose. Application sites should
be changed with each dose, especially if skin
irritation occurs.

NCLEX keys
Client needs category: Physiological integrity
Client needs subcategory: Pharmacological
and parenteral therapies
Cognitive level: Application
6. A client experiences acute myocardial
ischemia. The nurse administers oxygen and
sublingual nitroglycerin. When assessing an
electrocardiogram (ECG) for evidence that
blood flow to the myocardium has improved,
the nurse should focus on the:
1. widening of the QRS complex.
2. frequency of ectopic beats.
3. return of the ST segment to baseline.
4. presence of a significant Q wave.
Answer: 3. During episodes of myocardial
ischemia, an ECG may show ST-segment
elevation or depression. With successful
treatment, the ST segment should return to
baseline. Widening QRS complex, presence
of a Q wave, and frequent ectopic beats arent
directly indicative of myocardial ischemia.

NCLEX keys
Client needs category: Physiological integrity
Client needs subcategory: Pharmacological
and parenteral therapies
Cognitive level: Application

4/8/2010 7:01:54 PM

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