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. While adequate hydration is generally beneficial, pericarditis management does not typically require aggressive fluid intake, and overhydration could exacerbate complications, especially if there is concurrent heart failure.

B. This statement is not relevant to pericarditis, as having pericarditis does not necessitate avoidance of driving unless there are specific complications or comorbidities.

C. NSAIDs are used to reduce inflammation and pain in pericarditis; sexual activity is not contraindicated while on these medications unless the client is experiencing symptoms that limit activity.

D. This indicates understanding because chest pain can signify worsening pericarditis or complications such as cardiac tamponade or myocardial involvement, and prompt evaluation is necessary.

A. A patient who has crackles bilaterally in the lung bases and is receiving oxygen with oxygen saturation of 95% B. A patient who is receiving IV nitroglycerin and has a blood pressure of 108/62 C. A patient who is cool and clammy, with new-onset confusion and restlessness D. A patient who reported dry cough after receiving the first dose of captopril

Correct Answer is C

Explanation

Rationale:
A. This patient shows signs of mild pulmonary congestion, but oxygen saturation is within an acceptable range and the patient is currently stable.

B. While this patient is on a vasodilator and has borderline low blood pressure, they are hemodynamically stable at this moment and not showing signs of acute deterioration.

C. This patient exhibits signs of poor perfusion and possible cardiogenic shock, which is life-threatening. These symptoms indicate an urgent priority for assessment and intervention.

D. This is a common side effect of ACE inhibitors and is non-emergent; the patient is stable and does not require immediate assessment

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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 teaching a client about the management of pericarditis. Which off the following client statements indicates to the nurse an understanding of the teaching?

Correct Answer is D

Explanation

After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first?

Correct Answer is C

Explanation

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