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 B

Explanation

Choice A rationale
Assessing the need for smoking cessation is a standard part of nursing care, especially for patients with circulatory issues. Smoking can exacerbate circulatory problems and delay wound healing.
Choice B rationale
Applying TED hose to bilateral legs might not be appropriate for this patient. TED hose are compression stockings designed to prevent deep vein thrombosis and promote circulation.
However, in a patient with weak pedal pulses and a full-thickness wound on the leg, the compression from the stockings could potentially worsen circulation to the area and impede wound healing.
Choice C rationale
Consulting physical therapy could be beneficial for this patient. Physical therapists can provide exercises and interventions to improve circulation and mobility, which could help with the patient’s circulatory issues and wound healing.
Choice D rationale
Obtaining an Ankle-Brachial Index (ABI) with a hand-held Doppler could be useful in this situation. The ABI is a simple, non-invasive test that can help diagnose peripheral artery disease (PAD), a condition that could be causing the patient’s weak pedal pulses and wound healing issues.

A. Daily alcohol use. B. Myocardial infarction (MI). C. Asthma. D. Peptic ulcer disease.

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.

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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

The nurse is caring for a client with weak pedal pulses, absent hair on bilateral legs, and a full-thickness wound on the right lateral malleolus with defined margins, including a minimal amount of serous exudate. Which of the following interventions is contraindicated?

Correct Answer is B

Explanation

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

A nurse is caring for a client who has developed cardiac tamponade. Which of the following symptoms should the nurse expect to observe?

An obese post-surgical patient reports sudden discomfort in her leg. Upon assessment, the nurse finds the leg to be cold and pale, with no pedal or popliteal pulse. What should the nurse suspect?

How would a nurse best describe the assessment of stasis dermatitis in a patient with peripheral vascular disease (PVD)?

The standard policy on the cardiac unit states, “Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg.”. Which patient should the nurse call the health care provider about?

Coarctation of the aorta refers to the local narrowing of the aorta near which location?

After the shift change, which patient in the emergency department should the nurse prioritize for assessment?

A 56-year-old individual visits his primary care provider for a routine checkup.The physical examination reveals edema, an enlarged liver (hepatomegaly), and muffled heart sounds. Which of the following findings should the nurse be most concerned about?