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A nurse is caring for a client post cardiac catheterization via the right groin site. The nurse is aware that which of the following findings needs to be reported to the interventional cardiologist as soon as it is identified.

Swelling at the insertion site and cool extremity

Oozing blood from the insertions site

The client has not voided since returning to recovery.

Blood pressure reading of 110/70 and heart rate of 90

Answer and Explanation

The Correct Answer is A

Rationale:

A. Swelling at the insertion site and cool extremity may indicate bleeding or hematoma formation at the site.

B. Oozing blood from the insertion site is expected immediately after a cardiac catheterization.

C. The client has not voided since returning to recovery is not related to the cardiac catheterization.

D. Blood pressure reading of 110/70 and heart rate of 90 are within normal limits.

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Correct Answer is ["A","C","D"]

Explanation

Rationale:

A. Preventing vagal stimulation can help prevent bradycardia.

B. Acute pain is not typically associated with sinus bradycardia.

C. Preventing falls is important because bradycardia can lead to dizziness and falls.

D. Assessing for neurologic changes is important because bradycardia can affect cerebral perfusion.

E. Monitoring fluid volume excess is not directly related to sinus bradycardia.

A. Diminished breath sounds B. Increased blood pressure C. Diminished heart sounds D. New systolic murmur

Correct Answer is C

Explanation

Rationale:

A. Diminished breath sounds are not typically associated with a pericardial effusion.

B. Increased blood pressure is not typically associated with a pericardial effusion but it can instead result in hypotension due to decreased cardiac output due to compression of the heart by the accumulated fluid.

C. The heart sounds may become faint or distant due to fluid accumulation around the heart.

D. A new systolic murmur may indicate a pericardial effusion and should be further evaluated.

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A nurse is caring for a client post cardiac catheterization via the right groin site. The nurse is aware that which of the following findings needs to be reported to the interventional cardiologist as soon as it is identified.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has undergone diagnostic testing and received a diagnosis of sinus bradycardia. Which interventions are most appropriate and should be included in the client's plan of care? (SELECT ALL THAT APPLY)

Correct Answer is ["A","C","D"]

Explanation

A nurse is caring for a client in a critical care unit who is 4 hours post operative coronary artery bypass surgery. The nurse performs the reassessment and suspects the client may be developing a pericardial effusion. What assessment findings would the nurse note in this case?

Correct Answer is C

Explanation

The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing action?

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