After receiving a change-of-shift report on four patients, which patient would the nurse assess first?.

Patient with dilated cardiomyopathy who has bilateral crackles at the lung bases.

Patient with acute aortic regurgitation whose blood pressure is 86/54 mm Hg.

Patient with infective endocarditis who has a murmur and splinter hemorrhages.

Patient with rheumatic fever who has sharp chest pain with a deep breath.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While bilateral crackles at the lung bases indicate fluid accumulation, a common symptom of dilated cardiomyopathy, it’s not as immediately life-threatening as some other conditions.

Choice B rationale:

Acute aortic regurgitation can lead to a rapid and severe drop in blood pressure, which is a medical emergency. Therefore, this patient should be assessed first.

Choice C rationale:

While a murmur and splinter hemorrhages are symptoms of infective endocarditis, they are not as immediately life-threatening as acute aortic regurgitation.

Choice D rationale:

Sharp chest pain with a deep breath could be a symptom of rheumatic fever, but it’s not as immediately life-threatening as acute aortic regurgitation.

So, the correct answer is Choice B, after analyzing all choices.

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Correct Answer is A

Explanation

Choice A rationale:

An irregular pulse could indicate that myocarditis is affecting the heart’s electrical system, leading to an irregular heartbeat or arrhythmia. This could potentially affect the action of digoxin, a medication used to treat heart conditions, and therefore should be communicated to the healthcare provider.

Choice B rationale:

Leukocytosis, or a high white blood cell count, can be a sign of infection or inflammation, including myocarditis. However, it is not as specific as an irregular pulse in indicating a potential issue with the administration of digoxin.

Choice C rationale:

Generalized myalgia, or muscle pain, can be a symptom of myocarditis. However, it is not as directly related to the action of digoxin as an irregular pulse.

Choice D rationale:

Fatigue can be a symptom of myocarditis. However, it is not as directly related to the action of digoxin as an irregular pulse.

So, the correct answer is A, after analyzing all choices.

A. "The pain is level 3 to 5 (0 to 10 scale).”. B. "The pain has gotten worse over the last week.”. C. "The pain wakes me up at night.”. D. "The pain goes away with a nitroglycerin tablet.”. .

Correct Answer is D

Explanation

Choice A rationale:

The pain level of 3 to 5 on a scale of 0 to 10 does not specifically indicate chronic stable angina.

Choice B rationale:

Pain that has worsened over the last week could indicate a number of conditions, not specifically chronic stable angina.

Choice C rationale:

Pain that wakes a patient up at night could be a sign of a number of conditions, not specifically chronic stable angina.

Choice D rationale:

Chronic stable angina is characterized by chest pain that is relieved by rest or nitroglycerin. Therefore, if the patient’s pain goes away with a nitroglycerin tablet, it would help confirm a diagnosis of chronic stable angina.

So, the correct answer is Choice D, after analyzing all choices.

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After receiving a change-of-shift report on four patients, which patient would the nurse assess first?.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a patient with myocarditis before giving a scheduled dose of digoxin (Lanoxin). Which finding is most important for the nurse to communicate to the health care provider?.

Correct Answer is A

Explanation

Which patient statement would help the nurse confirm the previous diagnosis of chronic stable angina?.

Correct Answer is D

Explanation

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