During a stress test on a treadmill, which observation by the nurse would necessitate immediate action?

Sinus tachycardia at a rate of 110 beats/min.

Blood pressure increase from 134/68 to 150/80 mm Hg.

The patient reports feeling tired.

Inversion of T waves on the electrocardiogram.

Answer and Explanation

The Correct Answer is D

Choice A rationale
Sinus tachycardia at a rate of 110 beats/min is a normal response to exercise. During a stress test, the heart rate will naturally increase as the body’s demand for oxygen increases. A heart rate of 110 beats/min is within the expected range during moderate exercise.
Choice B rationale
An increase in blood pressure from 134/68 to 150/80 mm Hg is a normal response to exercise. During a stress test, blood pressure will naturally rise as the heart works harder to pump blood to the muscles. This increase is within the expected range during moderate exercise.
Choice C rationale
Feeling tired during a stress test on a treadmill is a normal response to exercise. Fatigue can occur as the body’s energy stores are used up during physical activity. However, if the patient reports extreme fatigue or other symptoms such as chest pain or shortness of breath, it may indicate a problem.
Choice D rationale
Inversion of T waves on the electrocardiogram during a stress test is a sign of myocardial ischemia, a condition in which the heart muscle is not getting enough oxygen. This could indicate the presence of significant coronary artery disease and is a finding that would necessitate immediate action.

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Correct Answer is ["B","C","D"]

Explanation

Choice A rationale
Rheumatoid arthritis is an autoimmune disease that primarily affects the joints. While it can increase the risk of cardiovascular disease due to systemic inflammation, it is not typically considered a direct cause of secondary hypertension.
Choice B rationale
Coarctation of the aorta, a congenital condition characterized by a narrowing of the aorta, can cause secondary hypertension. This is because the narrowing can increase resistance to blood flow, leading to increased pressure.
Choice C rationale
Increased intracranial pressure (ICP) can cause secondary hypertension as part of Cushing’s reflex, a physiological response to protect the brain from damage. This reflex can lead to an increase in systemic blood pressure in an attempt to maintain cerebral perfusion.
Choice D rationale
Renal disease is a common cause of secondary hypertension. The kidneys play a crucial role in regulating blood pressure, and damage to the kidneys can lead to hypertension.
Choice E rationale
Colon cancer is not typically associated with secondary hypertension. While some cancers can produce substances that increase blood pressure, colon cancer is not commonly associated with this phenomenon.

A. Encourage exercise to increase heart rate. B. Administer a diuretic to decrease volume. C. Give an antibiotic to decrease infection. D. Apply oxygen to increase myocardial oxygen supply.

Correct Answer is D

Explanation

Choice A rationale
Encouraging exercise to increase heart rate in a patient with myocardial ischemia could potentially worsen the condition. Exercise increases the demand for oxygen in the heart, which may not be met due to the reduced blood flow in ischemia, potentially leading to further damage.
Choice B rationale
Administering a diuretic to decrease volume is not the most beneficial intervention for a patient with myocardial ischemia. While diuretics can reduce the workload of the heart by decreasing blood volume, they do not directly address the issue of reduced blood flow to the heart muscle that characterizes ischemia.
Choice C rationale
Giving an antibiotic to decrease infection is not relevant in this context. Myocardial ischemia is not caused by an infection, but by a reduction in blood flow to the heart muscle, often due to a blockage in one or more of the coronary arteries.
Choice D rationale
Applying oxygen to increase myocardial oxygen supply is the most beneficial intervention for a patient with myocardial ischemia. Oxygen therapy can help to meet the oxygen demand of the heart muscle when blood flow is reduced, alleviating symptoms and preventing further damage.

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During a stress test on a treadmill, which observation by the nurse would necessitate immediate action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following conditions are potential causes of secondary hypertension? (Select all that apply)

Correct Answer is ["B","C","D"]

Explanation

A 49-year-old male presents with chest pain. An EKG reveals ST elevation, and he is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial for this patient?

Correct Answer is D

Explanation

A client is admitted to the telemetry unit with an episode of substernal chest pain. His diagnostic studies reveal an elevated ST segment on the electrocardiogram (ECG) and an elevated cardiac troponin level. What would be an appropriate initial nursing goal?

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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?

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

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

What is included in the first-line therapeutic approach to lowering blood pressure in a patient diagnosed with essential hypertension? (Select all that apply)

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