A nurse accompanies a client to an exercise stress test. The client can achieve the target heart rate, but the electrocardiogram indicates ST-segment elevation. Which procedure will the nurse prepare the patient for?
cardiac catheterization
transesophageal echocardiogram
telemetry monitoring
pharmacologic stress test
The Correct Answer is A
ST-segment elevation during exercise stress testing is a concerning finding that may indicate reduced blood flow to the heart muscle. It can be a sign of myocardial ischemia or coronary artery disease. Cardiac catheterization is a diagnostic procedure that allows direct visualization of the coronary arteries and helps identify any blockages or narrowing that may be causing the ST-segment elevation.
Here's an explanation of why the other options are not the most appropriate procedures:
Transesophageal echocardiogram: Transesophageal echocardiogram (TEE) is a diagnostic test that involves inserting a probe into the esophagus to obtain detailed images of the heart. It is not typically used to evaluate ST-segment elevation, which primarily indicates coronary artery issues rather than structural abnormalities.
Telemetry monitoring: Telemetry monitoring involves continuous monitoring of a patient's heart rhythm and can be used for various cardiac conditions. While telemetry monitoring may be necessary for ongoing cardiac assessment, it is not a specific procedure to address the ST-segment elevation found during the exercise stress test.
Pharmacologic stress test: A pharmacologic stress test is an alternative to an exercise stress test for patients who cannot exercise. It involves administering medications that stimulate the heart to mimic the effects of exercise. While a pharmacologic stress test can also reveal ST-segment changes, the presence of ST-segment elevation usually requires further evaluation with a more invasive procedure like cardiac catheterization.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Based on the information provided, the nurse should anticipate that the medical treatment prescribed for a client with an abdominal aortic aneurysm less than 3 cm in size would be regular ultrasound screenings every six (6) months.
Monitoring the size of the abdominal aortic aneurysm through ultrasound is a common approach for managing small aneurysms. Regular ultrasound screenings allow healthcare providers to track the growth rate of the aneurysm and determine if any intervention, such as surgical repair, is necessary as the aneurysm progresses in size.
Let's review the other options and explain why they are not the most appropriate treatments for an abdominal aortic aneurysm less than 3 cm in size:
Intravenous pyelogram yearly: An intravenous pyelogram is an imaging test used to evaluate the urinary system, specifically the kidneys, ureters, and bladder. It is not directly related to the management or monitoring of an abdominal aortic aneurysm.
Assessment of abdominal girth monthly: Assessing the abdominal girth may be a part of the overall assessment of the client's condition, but it is not the primary treatment for managing an abdominal aortic aneurysm. Monitoring the aneurysm size through regular ultrasound screenings is a more specific and accurate approach.
Repair of abdominal aortic aneurysm: Repair of an abdominal aortic aneurysm is typically indicated when the aneurysm reaches a certain size threshold or if it poses a high risk of rupture. For an aneurysm less than 3 cm in size, repair is usually not the initial treatment option. Instead, regular monitoring through ultrasound screenings is recommended to assess the aneurysm's growth rate and determine the appropriate time for intervention.
Correct Answer is D
Explanation
Among the given findings, the most important finding to report to the health care provider in a client with a hypertensive emergency is the new-onset blurry vision and facial asymmetry. These symptoms may indicate that the client is experiencing a hypertensive crisis with potential complications such as hypertensive encephalopathy or stroke.
Blurred vision and facial asymmetry are concerning neurological symptoms that suggest possible damage to the blood vessels or organs in the brain. It is crucial to notify the health care provider immediately so that appropriate interventions can be initiated to address the underlying cause and prevent further complications.
While the other findings may also be associated with elevated blood pressure, the new-onset blurry vision and facial asymmetry indicate possible neurological involvement and require immediate attention. Headache, epistaxis (nosebleed), and decreased urine output may be significant symptoms, but the potential neurological implications make the new-onset blurry vision and facial asymmetry the priority for reporting.
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