The nurse is assessing a client with a heart rate of 124 bpm. What clinical ﬁnding(s) should the nurse assess as causes of tachycardia? Select all that apply.

Blood glucose 90 mg/dL

Pain level of 10 out of 10

Temperature 101.9 F

Hemoglobin: 7g/dl

Cocaine abuse

Answer and Explanation

Correct Answer : B,C,D,E

Pain level of 10 out of 10: Severe pain can stimulate the sympathetic nervous system and result in an increased heart rate.

Temperature 101.9°F: Fever can lead to an elevated heart rate as the body's response to infection or inﬂammation.

Hemoglobin: 7 g/dL: Low hemoglobin levels, known as anemia, can cause the heart to pump faster in an attempt to compensate for the decreased oxygen-carrying capacity of the blood.

Cocaine abuse: Cocaine is a stimulant drug that can signiﬁcantly increase heart rate and cause tachycardia.

The following clinical ﬁnding would not typically be associated with tachycardia:

Blood glucose 90 mg/dL: While low or high blood glucose levels can cause symptoms, they are not directly associated with tachycardia unless they lead to signiﬁcant physiological stress or hormonal imbalances.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

Based on the information provided, an Ankle-Brachial Index (ABI) of 0.89 indicates a mild reduction in blood flow to the lower extremities, suggesting peripheral arterial disease (PAD). In this case, the nurse should educate the client about the use of compression stockings.

Compression stockings are a conservative management approach for peripheral arterial disease. They help improve blood flow and alleviate symptoms by applying pressure to the legs, promoting venous return, and reducing swelling. Educating the client about the use of compression stockings can help improve circulation and manage symptoms such as pain, cramping, and fatigue.

Let's review the other options and explain why they are not the most appropriate interventions in this scenario:

Document the information as a normal finding: An ABI of 0.89 indicates an abnormal finding suggestive of peripheral arterial disease. It should not be documented as a normal finding, as it requires further assessment and intervention.

Prepare the client for an arterial bypass: An arterial bypass is a surgical intervention that is typically reserved for more severe cases of peripheral arterial disease. With an ABI of 0.89, which indicates mild reduction in blood flow, arterial bypass is not the first-line intervention. Conservative measures and medical management are usually recommended initially.

Anticipate a prescription for clopidogrel and simvastatin: Medications like clopidogrel (antiplatelet) and simvastatin (statin) may be prescribed for peripheral arterial disease. However, the next appropriate step after obtaining an ABI of 0.89 would be to educate the client about the use of compression stockings as a conservative management option before considering medication therapy.

A. "Increased LDL and decreased HDL increase my risk of coronary artery disease." B. "Increased LDL has the potential to decrease my risk of heart disease." C. "The decreased HDL level will increase the amount of cholesterol moved away from the artery walls." D. "The increased LDL will decrease the amount of cholesterol deposited on the artery walls."

Correct Answer is A

Explanation

Elevated levels of LDL (low-density lipoprotein) cholesterol are associated with an increased risk of coronary artery disease (CAD). LDL cholesterol is often referred to as "bad" cholesterol because it can contribute to the formation of plaque in the arteries, leading to narrowing and blockage of the arteries supplying the heart. This increases the risk of developing CAD and related complications such as heart attack and stroke.

On the other hand, HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. HDL cholesterol helps remove excess cholesterol from the bloodstream and transport it back to the liver for processing and excretion. Higher levels of HDL cholesterol are associated with a decreased risk of CAD because it helps to prevent the accumulation of cholesterol on artery walls.

Therefore, understanding that increased LDL and decreased HDL levels increase the risk of coronary artery disease demonstrates a good understanding of the significance of cholesterol levels and their impact on cardiovascular health.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is assessing a client with a heart rate of 124 bpm. What clinical ﬁnding(s) should the nurse assess as causes of tachycardia? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client with a presumptive diagnosis of peripheral arterial disease. The nurse obtains an Ankle-Brachial index of 0.89. Which intervention should the nurse take next?

Correct Answer is C

Explanation

The nurse is conducting client teaching about cholesterol levels. When discussing the client's elevated LDL and lowered HDL levels, the client shows an understanding of the significance of these levels by making what statement?

Correct Answer is A

Explanation

The nurse and unlicensed assistive personnel (UAP) on the telemetry unit are caring for four clients. Which nursing action can be delegated to the UAP?

The nurse is assessing a client with a heart rate of 124 bpm. What clinical ﬁnding(s) should the nurse assess as causes of tachycardia? Select all that apply.

The nurse is reviewing the medical records of a client with atrial fibrillation. Which prescription should the nurse question?

The nurse is reviewing the medical electronic record of a client with abdominal aortic aneurysm less than 3 cm in size. Which medical treatment should the nurse anticipate to be prescribed for the client?

While assessing a client, the nurse notes that the client's ankle-brachial index (ABI) of the right leg is 0.40. How should the nurse best follow up this assessment ﬁnding?

The nurse is screening a client prior to an magnetic resonance imaging (MRI). What information is important to report to the health care provider before the MRI?

The nurse is interviewing a client with a complex cardiac history. Which questions related to the client's history are most important to ask? Select all that apply.

The nurse has written a plan of care for a client diagnosed with peripheral arterial insufficiency. Which intervention is the most appropriate for this diagnosis?