A client is brought to the emergency department by ambulance with chest pain 10/10 which began 30 minutes prior. The client's troponin levels are 1.20 ng/mL and an ST-elevation is noted on the electrocardiogram (ECG). The nurse understands that the priority intervention for this patient is which of the following?

Transport the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI).

Begin aggressive diuresis with furosemide and obtain an order for digoxin.

Prepare the patient for synchronized cardioversion and radiofrequency catheter ablation.

Administer gemfibrozil (Lopid) while preparing the client for a cardiac stress test.

Answer and Explanation

The Correct Answer is A

A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.

Nursing Test Bank

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Correct Answer is C

Explanation

A. Atrial fibrillation is characterized by an irregularly irregular rhythm and absence of distinct P-waves.
B. Atrial flutter typically presents with "saw-tooth" flutter waves rather than extra P-waves.
C. Premature atrial contractions (PACs) are identified by the presence of extra P-waves on an ECG.
D. Stable angina is related to chest pain and does not have specific ECG findings such as extra P-waves.

A. we excess ADAMTS-13 from your plasma B. large von Willebrand factor molecules from your plasma C. macrophages from your spleen D. performed once a week until your platelet counts normalize.

Correct Answer is B

Explanation

A. Plasmapheresis in TTP aims to remove abnormal blood components, not ADAMTS-13. In fact, plasmapheresis helps replenish ADAMTS-13.
B. The primary goal of plasmapheresis in TTP is to remove large von Willebrand factor molecules that are causing platelet aggregation and clot formation.
C. Removing macrophages from the spleen is not the objective of plasmapheresis.
D. Plasmapheresis is usually performed daily until clinical and laboratory parameters improve, not just once a week.

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Naxlex Comprehensive Predictor Exams

A client in an urgent care clinic states "My heart feels like it is skipping beats every now and then." A 12-lead electrocardiogram (ECG) shows a extra P-wave. The nurse should understand that this ECG finding represents which of the following conditions?

Correct Answer is C

Explanation

A nurse is caring for a client who has been diagnosed with thrombotic thrombocytopenic purpura (TTP) and will begin plasmapheresis ment should the nurse plan to include when educating the client about this treatment?

Correct Answer is B

Explanation

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelets are low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?

A nurse on an oncology unit is preparing to administer daunorubicin to a client who has leukemia. Which action should the nurse take before administering this medication?

The nurse is caring for a client who has left-sided heart failure. Which statement made by the patient would be consistent with left-sided heart failure?

A nurse on a telemetry unit is caring for four clients. Which of the following clients is experiencing potential manifestations of a myocardial infarction?

A nurse receives report on four clients at the beginning of the shift. Which of the following clients should the nurse place priority on assessing first?

A client with immune thrombocytopenic purpura (ITP) will begin treatment with romiplostim (Nplate) to be administered by subcutaneous injection in the provider's office once per week. Which statement should the nurse plan to include when educating the client about this medication?