A nurse is assessing clients on a medical-surgical unit. Which client would the nurse identify as being at greatest risk for atrial fibrillation?

An 80-year-old with chronic obstructive pulmonary disease.

A 78-year-old who had a carotid endarterectomy.

A 45-year-old who takes an aspirin daily.

A 50-year-old who is post coronary artery bypass graft surgery.

Answer and Explanation

The Correct Answer is A

A. Atrial fibrillation (AF) is more common in older adults, particularly those with underlying conditions like chronic obstructive pulmonary disease (COPD). COPD can lead to structural changes in the heart, increasing the risk of AF. The elderly are particularly vulnerable due to age-related heart changes and comorbidities such as lung disease.

B. While carotid endarterectomy is a surgical procedure that can be related to stroke prevention, it is not directly associated with a higher risk of AF compared to COPD.

C. Aspirin is used for its antiplatelet effects, not directly related to the risk of AF.

D. Post coronary artery bypass graft (CABG) surgery increases the risk for arrhythmias, but it is less directly linked to AF than conditions like COPD in an older adult.

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Correct Answer is C

Explanation

A. A mild pain level of 3/10 is common after angioplasty and is not immediately concerning.

B. Minimal bruising at the groin is expected after this procedure and is not alarming.

C. A weakened pedal pulse and a cool leg could indicate compromised circulation, which is a serious concern post-angioplasty. Immediate assessment is needed to check for possible complications such as re-occlusion.

D. A blood pressure of 154/78 mmHg is somewhat elevated but not alarming.

A. Client who needs a beta blocker, and has a blood pressure of 98/58 mm Hg. B. Hypertensive client with a blood pressure of 156/90 mm Hg. C. Client who needs pain medication prior to a dressing change of a surgical wound. D. Client who had a first dose of captopril and needs to use the bathroom.

Correct Answer is A

Explanation

A. A client with low blood pressure (98/58 mm Hg) who requires a beta blocker should be seen first because beta blockers can lower blood pressure further, possibly leading to hypotension or dizziness.

B. A hypertensive client with a blood pressure of 156/90 mm Hg is stable and does not require immediate intervention.

C. While pain medication is important, it is not as urgent as addressing a client with low blood pressure and a medication that can worsen the condition.

D. The client who just had captopril can wait to use the bathroom, as the priority is addressing their blood pressure and captopril's effect.

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A nurse is assessing clients on a medical-surgical unit. Which client would the nurse identify as being at greatest risk for atrial fibrillation?

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