A 22-year-old patient presents with fatigue, chest discomfort, and palpitations. Vital signs show HR 112 bpm. BP 98/5, and low-grade fever. The nurse notes irregular heart sounds and severe pedal edema. Which condition should the nurse suspect? (Select All that Apply.)

Pneumonia

Heart failure

COPD

Atrial fibrillation

Pulmonary embolism

Answer and Explanation

Correct Answer : B,D

Rationale:

A. While pneumonia can cause fever, fatigue, and chest discomfort, it is less likely to cause severe pedal edema, irregular heart rhythms, or palpitations. The presence of edema and irregular heart sounds points toward a cardiac origin rather than a primary pulmonary infection.

B. Fatigue, chest discomfort, irregular heart sounds, pedal edema, and low blood pressure are classic signs of heart failure, particularly in a young adult who may have acute or chronic cardiac dysfunction. Heart failure can also contribute to the development of arrhythmias.

C. COPD primarily presents with chronic cough, dyspnea, and sputum production. While it can strain the heart over time, COPD alone would not account for the acute irregular heart rate, edema, and chest discomfort in this patient.

D. The irregular heart rate (HR 112 bpm) and irregular heart sounds are indicative of atrial fibrillation, which is common in patients with underlying heart disease or heart failure. Atrial fibrillation can also worsen cardiac output, contributing to edema and fatigue.

E. Pulmonary embolism typically presents with acute dyspnea, pleuritic chest pain, tachypnea, and sometimes hemoptysis. Edema and irregular heart rhythms are not primary features, making this less likely than heart failure and atrial fibrillation.

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Correct Answer is D

Explanation

Rationale:
A. This is a long-term treatment for recurrent VT or other arrhythmias. It is not an immediate intervention for acute, unstable VT.

B. Cardiopulmonary resuscitation is performed only if the client is pulseless and unresponsive. While CPR may be necessary in cardiac arrest, it is not the first-line intervention for VT with a pulse.

C. Synchronized cardioversion is used for hemodynamically stable VT with a pulse, but the term “elective” implies a planned procedure, not emergency management.

D. For pulseless VT or VT causing severe instability (e.g., hypotension, altered mental status), defibrillation is the immediate lifesaving intervention. It delivers an unsynchronized shock to restore normal cardiac rhythm.

A. Bradycardia B. Abdominal pain C. Exertional dyspnea D. Peripheral edema

Correct Answer is C

Explanation

Rationale:
A. Chronic aortic regurgitation typically does not cause bradycardia; the heart often compensates for the increased volume load by maintaining a normal or slightly elevated heart rate to preserve cardiac output.

B. This symptom is not characteristic of aortic regurgitation. Any abdominal discomfort in cardiac patients is more likely related to comorbidities or advanced heart failure affecting liver congestion, not the valve disease itself.

C. Chronic aortic regurgitation leads to volume overload of the left ventricle, causing left ventricular dilation and eventually increased pulmonary venous pressure. This results in left-sided heart failure symptoms, such as exertional dyspnea, fatigue, and decreased exercise tolerance, which often appear gradually as the disease progresses.

D. Typically associated with right-sided heart failure, peripheral edema is not an early or primary symptom of isolated aortic regurgitation. It may appear only in advanced stages if biventricular failure develops.

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A 22-year-old patient presents with fatigue, chest discomfort, and palpitations. Vital signs show HR 112 bpm. BP 98/5, and low-grade fever. The nurse notes irregular heart sounds and severe pedal edema. Which condition should the nurse suspect? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?

Correct Answer is D

Explanation

Which of the following is a common symptom of chronic aortic regurgitation?

Correct Answer is C

Explanation

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