A nurse is caring for a client who experienced a femur fracture 8 hr ago and now reports sudden onset dyspnea and severe chest pain. Which of the following actions should the nurse take first?

Provide high-flow oxygen.

Administer an IV vasopressor medication.

Monitor the client for headache.

Check the client for a positive Chvostek's sign.

Answer and Explanation

The Correct Answer is A

A. Provide high-flow oxygen
The client may have a fat embolism. Oxygenation is the priority to prevent hypoxia and support vital organs.

B. Administer IV vasopressor
Vasopressors may help hypotension, but oxygenation comes first.

C. Monitor for headache
Headache is not the primary concern here.

D. Check for Chvostek’s sign
Chvostek’s sign is for hypocalcemia, unrelated to this emergency.

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Correct Answer is A

Explanation

A. Troponin
Troponin is the most specific and sensitive marker for myocardial injury. Levels rise within 3–6 hours of an MI.

B. C-reactive protein
CRP indicates inflammation and is nonspecific. It is not diagnostic for acute MI.

C. Brain natriuretic peptide (BNP)
BNP is used to evaluate heart failure, not primarily to diagnose MI.

D. Creatinine kinase (CK)
CK is a general marker of muscle injury; CK-MB is more specific for cardiac damage but is less accurate than troponin.

A. Decreased specific gravity B. Increased pulmonary artery wedge pressure (PAWP). C. Elevated central venous pressure (CVP). D. Decreased brain natriuretic peptide (BNP).

Correct Answer is C

Explanation

A. Decreased specific gravity
This is associated with diabetes insipidus or overhydration, not right-sided HF.

B. Increased PAWP
PAWP reflects left-sided heart pressures; not typically elevated in isolated right-sided failure.

C. Elevated CVP
Right-sided HF causes systemic venous congestion, increasing central venous pressure.

D. Decreased BNP
BNP levels increase with heart failure; decreased levels are not expected.

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A nurse is caring for a client who experienced a femur fracture 8 hr ago and now reports sudden onset dyspnea and severe chest pain. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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