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 inability to move the left arm and leg suggests a neurological deficit, which is a significant finding that requires immediate attention. It could indicate a potential stroke or another neurological emergency that requires prompt evaluation and intervention. The health care provider needs to be notified immediately so that appropriate diagnostic tests and interventions can be initiated.

Tremors in the fingers when extending the arms can be a sign of tremor disorders or medication side effects but may not warrant immediate intervention.

Atrial fibrillation is a cardiac arrhythmia that requires monitoring and management but may not be directly related to the acute neurological issue.

The headache reported by the patient, although significant, is subjective and may be related to the hypertensive emergency or other factors but does not require immediate intervention compared to the potential neurological deficit.

A. Obtain consent for transesophageal echocardiogram (TEE) B. Obtain consent for a STAT defibrillation C. Obtain consent for cardioversion. D. Hold digoxin 48 hours prior to cardioversion.

Correct Answer is B

Explanation

Defibrillation is not the first-line treatment for atrial fibrillation. It is used to treat life-threatening cardiac arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. Atrial fibrillation, on the other hand, is a rapid and irregular atrial rhythm, and defibrillation is not indicated for its treatment.

Obtain consent for transesophageal echocardiogram (TEE): This is an appropriate action for a client with atrial fibrillation. A TEE is often performed to assess the structure and function of the heart in cases of atrial fibrillation, especially when considering cardioversion or other interventions.

Obtain consent for cardioversion: Cardioversion is a common treatment option for atrial fibrillation, especially when the client is unstable or experiencing symptoms. It involves restoring a normal heart rhythm through the use of electrical shocks or medications. It is important to obtain informed consent before performing cardioversion, but this does not necessarily require questioning.

Hold digoxin 48 hours prior to cardioversion: Digoxin is commonly held before cardioversion because it can increase the risk of certain arrhythmias during the procedure. This is a standard precaution to minimize potential adverse effects. Therefore, the nurse does not need to question this action, as it aligns with established guidelines.

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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

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