A nurse on a telemetry unit is caring for a client who has a history of premature ventricular contractions (PVCs). The client reports feeling lightheaded and feeling heart beats in their chest. In a client having PVCs, which of the following findings would the nurse expect when auscultating the client's apical pulse?

Irregular pulsations

Bounding pulsations

Tachycardia

Bradycardia

Answer and Explanation

The Correct Answer is A

A. Irregular pulsations: Premature ventricular contractions (PVCs) are abnormal heartbeats originating in the ventricles, causing irregularities in the heart rhythm. Auscultating the apical pulse during PVCs may reveal irregular pulsations due to the irregular timing of ventricular contractions.

B. Bounding pulsations: Bounding pulsations are typically associated with conditions such as hypertension or aortic valve regurgitation but are not specifically characteristic of PVCs.

C. Tachycardia: PVCs may occur in the setting of tachycardia, but the presence of PVCs themselves does not necessarily indicate a rapid heart rate. The rhythm may be irregular due to PVCs, but the overall heart rate may not be consistently elevated.

D. Bradycardia: PVCs are not typically associated with bradycardia. Bradycardia refers to a slow heart rate, while PVCs involve premature extra beats originating from the ventricles.

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Correct Answer is D

Explanation

A. Client develops petechiae on the arms, legs, and abdomen: Petechiae can indicate thrombocytopenia, which may be a complication of heparin therapy but is not an urgent concern unless severe or associated with bleeding.

B. Health care provider orders Coumadin 2.5 mg P.O. to begin today: Coumadin (warfarin) is often initiated as a bridge therapy or overlap with heparin therapy in pulmonary embolism management. This order is not necessarily inappropriate and may be part of the treatment plan.

C. Client develops slight ecchymosis at the venipuncture site: Ecchymosis at the venipuncture site can occur due to minor trauma during the insertion of IV lines or blood draws and is not necessarily indicative of a complication requiring immediate notification of the healthcare provider.

D. Client's partial thromboplastin time (PTT) is 70 seconds and the control is 25-40 seconds: A significantly elevated PTT indicates a potential overdose of heparin, putting the client at risk of bleeding complications. This finding warrants immediate notification of the healthcare provider for further evaluation and possible adjustment of heparin therapy.

A. Freshly squeezed orange juice. B. Milk. C. Black Coffee. D. Sweetened iced tea.

Correct Answer is D

Explanation

A. Freshly squeezed orange juice: Orange juice is generally not considered a trigger for gout attacks. However, it is high in fructose, which may contribute to gout if consumed excessively.

B. Milk: Milk is not typically associated with triggering gout attacks and is often recommended as part of a healthy diet for gout.

C. Black Coffee: Coffee, especially black coffee, is generally considered safe for individuals with gout and may even have some protective effects against gout attacks.

D. Sweetened iced tea: Sweetened iced tea is often made with high-fructose corn syrup, which can increase uric acid levels and potentially trigger gout attacks. Therefore, it is important for individuals with gout to limit their intake of sweetened beverages like iced tea.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with a pulmonary embolism that is placed on a continuous heparin infusion. The nurse should notify the health care provider for which of the following findings?

Correct Answer is D

Explanation

A nurse is teaching a client who has gout about dietary recommendations. The nurse should teach the client that which of the following beverages can trigger an attack?

Correct Answer is D

Explanation

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