A nurse is planning care for a client who has suspected cardiac tamponade. Which of the following diagnostic tests should the nurse anticipate the provider to order first?

Computed tomography (CT) scan

Chest x-ray

Echocardiogram

Electrocardiogram (ECG)

Answer and Explanation

The Correct Answer is C

A) Computed tomography (CT) scan: A CT scan may provide detailed images of the heart and surrounding structures, but it is not typically the initial diagnostic test used to assess for cardiac tamponade. CT scans are often used in conjunction with other diagnostic tests but are not the first-line investigation for suspected tamponade.

B) Chest x-ray: While a chest x-ray may show signs of cardiac tamponade, such as an enlarged cardiac silhouette or evidence of fluid accumulation around the heart, it is not as sensitive or specific as other diagnostic tests, particularly in the acute setting. Chest x-rays may be obtained as part of the diagnostic workup, but they are not the first-line test for suspected tamponade.

C) Echocardiogram: An echocardiogram is the most appropriate initial diagnostic test for suspected cardiac tamponade. It provides real-time imaging of the heart and can detect pericardial effusion, collapse of the right atrium and ventricle during diastole (diastolic collapse), and signs of hemodynamic compromise. Echocardiography allows for rapid assessment at the bedside and can guide immediate management decisions.

D) Electrocardiogram (ECG): While an electrocardiogram may show nonspecific changes in cardiac tamponade, such as low-voltage QRS complexes or electrical alternans, it is not as sensitive or specific as an echocardiogram for diagnosing tamponade. ECG findings may support the diagnosis but are not typically the first-line test for suspected tamponade.

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Correct Answer is A

Explanation

A. Changes to social cognition and challenges to inhibitory control: Neurologic injuries such as increased intracranial pressure can lead to changes in social cognition, including difficulties in understanding social cues, interpreting emotions, and maintaining appropriate social interactions. Additionally, inhibitory control may be impaired, leading to impulsivity and disinhibition in behavior.

B. Improved mood stability and improved temper control: Neurologic injuries are more likely to result in mood instability and difficulties with temper control rather than improvement in these areas. Changes in mood, including irritability, anxiety, depression, and emotional lability, are common psychosocial consequences of neurologic injuries.

C. Improved rehabilitation outcomes and temporary behavior changes: While rehabilitation efforts may lead to improvement in functional abilities over time, neurologic injuries often result in persistent psychosocial challenges rather than improved outcomes. Temporary behavior changes may occur during the recovery process, but individuals may continue to experience long-term psychosocial sequelae.

D. Sense of purpose, improved motivation, and stable relationships: Neurologic injuries can significantly impact an individual's sense of purpose, motivation, and relationships. Clients may struggle to find meaning and motivation in their lives following a neurologic injury, and relationships may be strained due to changes in behavior, cognition, and communication.

A. Comply with compression therapy. B. Monitor wounds on lower extremities. C. Take antiplatelet medications as ordered. D. Monitor for gradual onset of symptoms

Correct Answer is D

Explanation

A. Comply with compression therapy: Compression therapy is commonly used in the management of peripheral vascular disease (PVD), not valvular heart disease. It involves applying external pressure to the limbs to improve circulation and reduce edema. While this intervention may be relevant for a client with PVD, it is not specific to valvular heart disease.

B. Monitor wounds on lower extremities: Monitoring wounds on lower extremities is important for clients with peripheral vascular disease (PVD) to assess for signs of poor wound healing, infection, or tissue ischemia. However, it is not directly related to valvular heart disease. Therefore, while wound monitoring may be appropriate for this client, it is not specific to valvular heart disease education.

C. Take antiplatelet medications as ordered: Antiplatelet medications, such as aspirin or clopidogrel, are commonly prescribed for clients with peripheral vascular disease (PVD) to reduce the risk of thrombotic events and improve blood flow. However, they are not typically indicated as a primary treatment for valvular heart disease. While some clients with valvular heart disease may have comorbidities that warrant antiplatelet therapy, it is not specific to valvular heart disease education.

D. Valvular heart disease involves dysfunction of one or more heart valves, leading to impaired blood flow within the heart. The nurse should educate the client on monitoring for the gradual onset of symptoms related to valvular heart disease. These symptoms may include dyspnea (shortness of breath), fatigue, palpitations, chest discomfort, and edema. Monitoring for these symptoms allows for early detection of disease progression or exacerbation, prompting timely intervention and management.

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A nurse is planning care for a client who has suspected cardiac tamponade. Which of the following diagnostic tests should the nurse anticipate the provider to order first?

Nursing Test Bank

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