A nurse is admitting a client who has a history of atrial fibrillation. Which of the following conditions should the nurse recognize atrial fibrillation places the client at risk for?

Hemothorax

Cardiac tamponade

Pulmonary emboli

Widened pulse pressure

Answer and Explanation

The Correct Answer is C

Rationale:
A. Hemothorax: Hemothorax is accumulation of blood in the pleural space, typically caused by trauma, surgery, or ruptured vessels. Atrial fibrillation does not directly increase the risk of hemothorax.

B. Cardiac tamponade: Cardiac tamponade occurs when fluid accumulates in the pericardial sac, impairing cardiac output. This condition is usually associated with trauma, pericarditis, or post-surgical complications, not atrial fibrillation.

C. Pulmonary emboli: Atrial fibrillation can lead to stasis of blood in the atria, especially the left atrial appendage, increasing the risk of thrombus formation. If a clot dislodges and travels to the lungs, it can cause a pulmonary embolism, making this a serious complication to monitor for.

D. Widened pulse pressure: Widened pulse pressure reflects the difference between systolic and diastolic blood pressure and is associated with conditions like aortic regurgitation. It is not a direct consequence of atrial fibrillation and is not considered a primary risk in these clients.

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Correct Answer is B

Explanation

Rationale:
A. Fibrocystic breast condition: Fibrocystic breast changes are benign and do not contraindicate oral contraceptive use. Oral contraceptives may sometimes improve symptoms, but this condition alone is not a reason to avoid them.

B. Hypertension: Oral contraceptives can elevate blood pressure and increase the risk of cardiovascular complications. Clients with uncontrolled or severe hypertension are at higher risk and should avoid combined estrogen-progestin contraceptives, making this a significant contraindication.

C. Asthma: Asthma is not a contraindication for oral contraceptive use. Hormonal contraceptives generally do not exacerbate asthma, and clients with well-controlled asthma can safely use these medications.

D. Fibromyalgia: Fibromyalgia is a chronic musculoskeletal pain disorder that does not affect cardiovascular or thrombotic risk. It is not a contraindication for oral contraceptives, and use is generally safe in these clients.

A. "Report bleeding that saturates the client's dressing." B. "Ensure the client's urinary output is no less than 20 mL per hour." C. "Expect the client to have a palpable distended bladder following surgery." D. "Maintain the client in a supine position for 24 hours following surgery."

Correct Answer is A

Explanation

Rationale:
A. "Report bleeding that saturates the client's dressing.": Excessive or saturating bleeding from a postoperative abdominal incision may indicate hemorrhage or disruption of the surgical site and requires immediate provider notification.

B. "Ensure the client's urinary output is no less than 20 mL per hour.": The expected minimum urinary output for an adult after surgery is at least 30 mL per hour, which reflects adequate renal perfusion and fluid balance. A urine output of 20 mL per hour is too low.

C. "Expect the client to have a palpable distended bladder following surgery.": A distended bladder is not expected postoperatively and may signal urinary retention, a common complication due to anesthesia or opioids.

D. "Maintain the client in a supine position for 24 hours following surgery.": Keeping the client supine for 24 hours increases the risk of respiratory complications, including atelectasis and pneumonia. The nurse should encourage early ambulation and semi-Fowler’s positioning.

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A nurse is admitting a client who has a history of atrial fibrillation. Which of the following conditions should the nurse recognize atrial fibrillation places the client at risk for?

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