A nurse receives report on four clients at the beginning of the shift. Which of the following clients should the nurse place priority on assessing first?

A client who had a myocardial infarction two days ago, and complains of soft stools after taking docusate sodium.

A client being treated for thrombotic thrombocytopenic purpura (TTP) who has had 120 mL of urine output in the last 12 hours.

A client who was admitted for premature atrial contractions (PACS) and whose most recent blood pressure is 148/89.

A client receiving furosemide for heart failure whose daily weight shows that he has lost 0.5 kg since yesterday.

Answer and Explanation

The Correct Answer is B

A. While soft stools after taking docusate sodium is noteworthy, it is not immediately life-threatening and does not require urgent intervention.
B. Oliguria (low urine output) in a client with TTP is concerning because it may indicate acute kidney injury or worsening of the condition, requiring immediate assessment and intervention.
C. An elevated blood pressure in a client with PACs is important but not as critical as potential kidney dysfunction in the TTP patient.
D. A weight loss of 0.5 kg in a client with heart failure on furosemide may be expected and does not require immediate intervention.

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Correct Answer is D

Explanation

A. While a platelet transfusion can temporarily increase platelet counts, it does not reduce the destruction of platelets in ITP and is generally not effective as a long-term solution.
B. Replacement of ADAMTS-13 is relevant in thrombotic thrombocytopenic purpura (TTP), not ITP. It is not used for reducing platelet destruction in ITP.
C. Protamine sulfate is an antidote for heparin overdose and does not address the platelet destruction in ITP.
D. A laparoscopic splenectomy is often considered for clients with ITP who do not respond to medication therapy. The spleen is a primary site for platelet destruction, and its removal can reduce the destruction of platelets, leading to increased platelet counts.

A. NSTEMI B. Stable angina C. STEMI D. Unstable angina

Correct Answer is D

Explanation

A. NSTEMI would present with elevated troponin levels indicating myocardial injury, which is not the case here.

B. Stable angina occurs predictably with exertion and is relieved by rest or nitroglycerin.

C. STEMI is characterized by ST-elevation on the ECG and elevated troponin levels, indicating significant myocardial injury.

D. Unstable angina presents with chest pain that occurs at rest or with minimal exertion and is not predictable. The presence of T-wave inversion and normal troponin levels is consistent with this diagnosis.

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A nurse receives report on four clients at the beginning of the shift. Which of the following clients should the nurse place priority on assessing first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelets are low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

A client with immune thrombocytopenic purpura (ITP) will begin treatment with romiplostim (Nplate) to be administered by subcutaneous injection in the provider's office once per week. Which statement should the nurse plan to include when educating the client about this medication?

A nurse is providing education before administering apixaban (Eliquis) to a client who has persistent atrial fibrillation. Which of the following statements made by the client indicates an understanding of the teaching?

A client has been diagnosed with chronic stable angina and has a new prescription for nitroglycerin tablets. Which statement about this medication should the nurse include in the patient education?

A client has been admitted repeatedly in the past year for episodes of atrial flutter which the cardiologist believes are caused by an area of conduction in the atria other than the SA node. Medications have not improved the condition. Which procedure should the nurse anticipate will be performed?

A nurse is providing education to a client with heart failure who will begin taking digoxin daily at home. Which of the following statements made by the client indicates an understanding of the teaching? (Select all that apply.)

A client is seen in the emergency department with a heart failure exacerbation due to noncompliance with medications and fluid restrictions. Which key diagnostic result should the nurse assess to determine the severity of the client's heart failure exacerbation?

A client in an urgent care clinic states "My heart feels like it is skipping beats every now and then." A 12-lead electrocardiogram (ECG) shows a extra P-wave. The nurse should understand that this ECG finding represents which of the following conditions?