After receiving the shift change report about four patients in the cardiac care unit, which patient should the nurse prioritize for assessment?

A 59-year-old patient with unstable angina who has just returned from a percutaneous coronary intervention (PCI).

A 56-year-old patient with variant angina due to receive nifedipine (Procardia).

A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and is anxious about discharge planned for today.

A 39-year-old patient with pericarditis complaining of sharp, stabbing chest pain.

Answer and Explanation

The Correct Answer is A

Choice A rationale
A 59-year-old patient with unstable angina who has just returned from a percutaneous coronary intervention (PCI) should be prioritized for assessment. PCI is a procedure to open blocked or narrowed coronary arteries and can lead to complications such as re-occlusion of the artery or bleeding from the catheter insertion site. Furthermore, unstable angina is a condition that can progress to myocardial infarction if not managed effectively.
Choice B rationale
A 56-year-old patient with variant angina due to receive nifedipine (Procardia) requires monitoring, but is not the highest priority. Variant angina is a form of angina that occurs at rest, often with severe pain, but it is usually well-controlled with medications like nifedipine.
Choice C rationale
A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and is anxious about discharge planned for today is a lower priority for assessment. While it’s important to address the patient’s anxiety and provide education about post-discharge care, this patient is not in immediate danger.
Choice D rationale
A 39-year-old patient with pericarditis complaining of sharp, stabbing chest pain requires assessment, but is not the highest priority. Pericarditis is inflammation of the pericardium, the sac-like covering of the heart, and while it can cause severe pain, it is not typically life- threatening.

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Correct Answer is C

Explanation

Choice A rationale
Daily alcohol use is not a direct contraindication for Propranolol (Inderal), but it’s important to note that alcohol can increase the blood pressure-lowering effect of propranolol, which can make you feel dizzy or lightheaded.
Choice B rationale
Propranolol is often used in the treatment of conditions related to heart disease, such as hypertension and angina, and it can also be used in the secondary prevention of myocardial infarction.
Choice C rationale
Asthma is a contraindication for the use of Propranolol (Inderal). Propranolol can cause bronchial constriction by blocking beta-adrenergic receptors in the lungs, which can exacerbate asthma symptoms.
Choice D rationale
Peptic ulcer disease is not a direct contraindication for Propranolol (Inderal). However, like any medication, Propranolol should be used with caution in patients with a history of peptic ulcer disease.

A. The patient smokes cigarettes. B. The patient eats bananas twice a day. C. The patient wears mittens outside. D. The patient takes calcium channel blockers.

Correct Answer is A

Explanation

Choice A rationale
Smoking cigarettes can exacerbate the symptoms of Raynaud’s disease by causing further constriction of the blood vessels. Therefore, a patient who continues to smoke cigarettes may need further education about the management of Raynaud’s disease.
Choice B rationale
Eating bananas twice a day is not typically a concern for patients with Raynaud’s disease.
Choice C rationale
Wearing mittens outside, especially in cold weather, is a recommended strategy for managing Raynaud’s disease. It can help to prevent episodes of Raynaud’s by keeping the hands warm and reducing exposure to cold temperatures.
Choice D rationale
Taking calcium channel blockers is a common treatment for Raynaud’s disease. These medications help to relax and open up the small blood vessels in the hands and feet, reducing the severity and frequency of Raynaud’s episodes.

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After receiving the shift change report about four patients in the cardiac care unit, which patient should the nurse prioritize for assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

If a patient diagnosed with hypertension is prescribed Propranolol (Inderal), what patient history should prompt the nurse to consult with the healthcare provider before administering this drug?

Correct Answer is C

Explanation

Which of the following findings in a patient with Raynaud’s disease would indicate a need for further teaching?

Correct Answer is A

Explanation

What patient data would indicate to the nurse that the infusion of a thrombolytic agent should be stopped in a patient with an acute myocardial infarction?

Upon receiving a change-of-shift report about four patients in a heart failure unit, which patient should the nurse prioritize for assessment?

When preparing a patient for a cardiac catheterization and coronary angiogram, which piece of information about the patient is crucial for the nurse to relay to the healthcare provider prior to the procedure?

What is the most appropriate advice for a patient suffering from arterial insufficiency?

Which patient statement indicates that the nurse’s teaching about sublingual nitroglycerin (Nitrostat) has been effective?

You are providing care to a patient with pericarditis. Which of the following is NOT a proper nursing intervention for this patient?