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

Answer and Explanation

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

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Correct Answer is C

Explanation

The client statement that supports the information of intermittent claudication is: "My legs get a painful cramp when I walk over 30 minutes.": Intermittent claudication is a symptom of peripheral artery disease (PAD) characterized by pain, cramping, or fatigue in the muscles of the lower extremities, typically the calves, thighs, or buttocks. This pain is usually triggered by physical activity, such as walking, and is relieved with rest. The pain is caused by inadequate blood flow and oxygen supply to the muscles due to narrowed or blocked arteries.

The other client statements do not specifically indicate intermittent claudication:

"My feet feel like I have pins and needles": This sensation of pins and needles is often associated with peripheral neuropathy, which is a condition involving nerve damage and does not directly relate to intermittent claudication.

"When I stand or sit too long, my feet swell": This statement suggests the possibility of venous insufficiency rather than intermittent claudication. Venous insufficiency involves impaired blood return from the legs to the heart and may result in swelling, aching, or heaviness in the legs.

"I get short of breath when I climb a lot of stairs": This symptom is more indicative of cardiovascular or respiratory issues, such as heart or lung disease, rather than intermittent claudication. It suggests that the client may experience exercise intolerance due to cardiopulmonary limitations.

A. The procedure stimulates the growth of new pathways between the atria B. The procedure uses cold therapy to stop the formation of the ﬂutter waves C. The procedure prevents or minimizes the patient's risk for sudden cardiac death D. The procedure uses electrical energy to destroy areas of the conduction system

Correct Answer is D

Explanation

The procedure uses electrical energy to destroy areas of the conduction system: Catheter ablation is a minimally invasive procedure performed to treat abnormal heart rhythms, such as atrial ﬂutter. During the procedure, a catheter is inserted into the heartand used to deliver electrical energy to speciﬁc areas of the heart tissue. This energy is used to destroy or ablate the abnormal conduction pathways that are causing the atrial ﬂutter.

Let's go through the other options and explain why they are not accurate:

The procedure stimulates the growth of new pathways between the atria: Catheter ablation does not stimulate the growth of new pathways. Instead, it aims to eliminate or modify existing abnormal pathways in the heart to restore normal electrical conduction.

The procedure uses cold therapy to stop the formation of the ﬂutter waves: Catheter ablation does not use cold therapy. It primarily utilizes radiofrequency energy or other sources of heat to ablate the targeted areas of the heart tissue.

The procedure prevents or minimizes the patient's risk for sudden cardiac death: While catheter ablation can be an effective treatment for certain arrhythmias, including atrial ﬂutter, it is not primarily performed to prevent or minimize the risk of sudden cardiac death. Its main purpose is to restore normal heart rhythm and alleviate symptoms associated with the arrhythmia.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client with intermittent claudication. What client statement supports this information?

Correct Answer is C

Explanation

The nurse is teaching a client with atrial ﬂutter who is scheduled for a catheter ablation? What should the nurse include in the teaching plan?

Correct Answer is D

Explanation

The nurse and unlicensed assistive personnel (UAP) are caring for four clients on a telemetry unit. Which nursing task would be best for the nurse to delegate to the UAP?

The nurse is caring for a client with a pacemaker/ICD on a continuous cardiac monitor. Which trace should require immediate follow up by the nurse? Select all that apply

The nurse and unlicensed assistive personnel (UAP) on the telemetry unit are caring for four clients. Which nursing action can be delegated to the UAP?

The nurse is caring for a client with sinus bradycardia at a rate of 32 beats/min, blood pressure (BP) of 80/42 mm Hg, and reports feeling faint. Which is the appropriate action?

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The nurse is assessing a client with a hypertensive emergency. Which finding is most important to report to the health care provider?

The nurse is admitting a client with Abdominal aortic aneurysm. Which assessment data would support the diagnosis?

The nurse has written a plan of care for a client diagnosed with peripheral arterial insufficiency. Which intervention is the most appropriate for this diagnosis?