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 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.

A. "Have you recently taken any antihistamines?" B. "Have there been recent stressful events in your life?" C. "Did you take any acetaminophen today?" D. "Have you consistently taken your medications?"

Correct Answer is D

Explanation

Choice D: This question is crucial as it addresses the client's adherence to their prescribed medication regimen for managing high blood pressure. Consistent medication use is essential for controlling blood pressure and reducing the risk of complications associated with hypertension. The elevated blood pressure reading suggests that the current medication regimen may not be effectively controlling the client's blood pressure. By assessing medication adherence, the nurse can determine if non-adherence is contributing to the high blood pressure reading or if adjustments to the medication regimen are required.

"Have you recently taken any antihistamines?": Asking about recent antihistamine use is not directly relevant to the client's high blood pressure reading of 210/106 mm Hg. Antihistamines are medications primarily used to relieve allergy symptoms and do not typically have a signiﬁcant impact on blood pressure levels.

"Have there been recent stressful events in your life?": While stress can contribute to temporary increases in blood pressure, asking about recent stressful events is not the most critical follow-up question in this situation. The client's blood pressure reading of 210/106 mm Hg indicates a severe elevation that requires immediate attention and management beyond stress reduction alone.

"Did you take any acetaminophen today?": Acetaminophen, also known as paracetamol, is a pain reliever and fever reducer. It does not typically have a signiﬁcant effect on blood pressure. Therefore, asking about acetaminophen use is not the most relevant follow-up question for the client's high blood pressure reading.

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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

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

A nurse is assessing a client with a history of high blood pressure. The client's blood pressure is 210/106 mm Hg during the assessment. What follow-up question should the nurse ask?

Correct Answer is D

Explanation

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