A nurse is collecting data on a client who has bradycardia. Which of the following findings should the nurse expect?

Fixed volume deficit

Anxiety

Lightheadedness

Elevated temperature

Answer and Explanation

The Correct Answer is C

Choice A reason : A fixed volume deficit, or hypovolemia, is not a direct finding associated with bradycardia. Bradycardia refers to a slower than normal heart rate, typically below 60 beats per minute in adults⁸. Hypovolemia can cause various compensatory mechanisms to activate, including an increase in heart rate to maintain cardiac output, which is the opposite of bradycardia. Therefore, a fixed volume deficit is not a typical finding in bradycardia unless it is part of a broader clinical picture⁹.

Choice B reason : Anxiety is a condition that can sometimes lead to an increased heart rate, known as tachycardia, rather than a decreased heart rate as seen in bradycardia. While anxiety can coexist with bradycardia, especially if the patient is anxious about their health, it is not a direct symptom or finding of bradycardia itself⁹.

Choice C reason : Lightheadedness is a common symptom of bradycardia. When the heart rate is too slow, it may lead to inadequate cerebral perfusion, which can cause a feeling of lightheadedness or dizziness. This symptom can be particularly evident when the patient changes positions, such as standing up quickly, which can exacerbate the effects of reduced cardiac output on cerebral blood flow⁸⁹.

Choice D reason : An elevated temperature is not typically associated with bradycardia. Fever can actually lead to an increased heart rate as the body attempts to manage the higher metabolic demands associated with a raised temperature. Bradycardia in the presence of fever might indicate a more complex clinical scenario, such as myocarditis or central nervous system infections, but it is not a direct finding of bradycardia⁹.

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Correct Answer is A

Explanation

Choice A reason : In atrial fibrillation, the heartbeat is known to be irregular and often rapid. This irregularity is due to the disorganized electrical signals in the heart's upper chambers, which cause a fast and chaotic heartbeat. Therefore, when documenting the pulse of a client with atrial fibrillation, the term "irregular" is appropriate.

Choice B reason : "Not palpable" would indicate that the pulse cannot be felt, which is not typically the case with atrial fibrillation. While the pulse may be irregular, it is usually still palpable unless the rate is extremely rapid or associated with other complications.

Choice C reason : "Bounding" refers to a pulse that feels strong and full. This is not characteristic of atrial fibrillation. Instead, the pulse in atrial fibrillation may feel weak and irregular due to the ineffective contraction of the atria.

Choice D reason : "Regular" is not an appropriate term to describe the pulse in a client with atrial fibrillation because the condition is characterized by an irregular heart rhythm. The term would be used for a pulse that has consistent beats at regular intervals, which is not the case in atrial fibrillation.

A. The frequency in which blood pressure is taken. B. Interventions implemented in response to a high blood pressure reading. C. The patient's response to interventions implemented. D. The person who obtained the blood pressure reading. E. The site where the blood pressure was obtained.

Correct Answer is A

Explanation

Choice A reason : Hepatomegaly, or the enlargement of the liver, is a common finding in right-sided heart failure. This condition occurs because the heart does not pump blood effectively, leading to congestion and increased pressure in the venous system, including the hepatic veins. As a result, the liver becomes engorged with blood, causing it to enlarge. The normal liver span in adults is about 10-12 cm in the midclavicular line, and any measurement above this can indicate hepatomegaly.

Choice B reason : Orthopnea, which is shortness of breath while lying flat, is more commonly associated with left-sided heart failure. In right-sided heart failure, symptoms are more related to systemic congestion, such as swelling in the legs and abdomen, rather than pulmonary symptoms like orthopnea.

Choice C reason : Dyspnea, or difficulty breathing, can be a symptom of both left and right-sided heart failure. However, in the context of right-sided heart failure, dyspnea is usually due to the accumulation of fluid in the abdominal cavity (ascites) and the increased pressure in the abdominal veins, which can compress the diaphragm and make breathing difficult.

Choice D reason : Frothy sputum is typically not a symptom of right-sided heart failure. It is more indicative of pulmonary edema, which is associated with left-sided heart failure. In right-sided heart failure, the primary issues are related to the systemic circulation and venous congestion.

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A nurse is collecting data on a client who has bradycardia. Which of the following findings should the nurse expect?

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