The nurse is caring for a client diagnosed with acute heart failure on the telemetry unit. Which laboratory result does the nurse know is most indicative of this diagnosis?

Hemoglobin 10.1 g/di (normal Female: 11.7-15.5 g/dL: Male: 14-17.3 g/dL

Brain natriuretic peptide 410 pg/mL (normal less than 100 pg/mL.)

Sodium 132 mEq/L (normal 135 - 145 mEq/L)

Fibrinogen level 201 mg/dL (normal 200-400 mg/dL)

Answer and Explanation

The Correct Answer is B

A.   A low hemoglobin level indicates anemia, not heart failure. While anemia can exacerbate heart failure, it is not the primary indicator.
B.   BNP is a biomarker that is elevated in response to heart failure. A level above 100 pg/mL is suggestive of heart failure, and 410 pg/mL indicates significant heart stress and likely acute heart failure.
C.   A low sodium level (hyponatremia) can occur in heart failure, but it is not specific enough to confirm the diagnosis. BNP is a more direct indicator of heart failure.
D.   This is a normal fibrinogen level and does not indicate heart failure. Fibrinogen is more associated with clotting disorders.

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Correct Answer is D

Explanation

A. Carotid massage can be used as a vagal maneuver for certain types of supraventricular tachycardia (SVT), particularly in stable patients. However, it is not recommended in cases where the patient has a history of cocaine use or is showing signs of instability because of the potential for triggering a serious event, like a stroke.
B. Adenosine is a medication commonly used for the treatment of SVT. However, it should be given with caution and only after assessing the patient's condition. In this case, the patient needs to be assessed first, including vital signs, level of consciousness, and overall stability, before any medications are administered.
C. Electrical cardioversion is indicated for unstable SVT (e.g., signs of hemodynamic instability such as hypotension, chest pain, or altered mental status). However, this patient is only reporting a "racing heart" and nervousness and has not yet been assessed for vital signs or other clinical symptoms.
D. The first step in this case should be to assess the patient's condition. This includes checking the vital signs, level of consciousness, and overall stability. Once this initial assessment is performed, the nurse can then determine whether medications or other interventions (like adenosine or cardioversion) are needed.

A. count the number of large squares in the R-R interval and divide by 30C B. print a 1-minute ECG strip and count the number of ORS complexes, C. count the number of QRS complexes in 6 seconds and multiply by 10. D. calculate the number of small squares between one QRS complex and the next one and divide by 1500.

Correct Answer is C

Explanation

A. Counting the number of large squares between R-R intervals and dividing by 30 is not the correct method for estimating the ventricular rate on an ECG strip.
B. Printing a 1-minute ECG strip and counting the QRS complexes (option B) is accurate but unnecessary for a quick estimation.
C. The most common and efficient method for estimating the ventricular rate quickly is to count the number of QRS complexes in a 6-second strip (often marked by two dashed lines) and multiply by 10. This gives an estimate of the heart rate per minute.
D. Counting the number of small squares between QRS complexes and dividing by 1500 is the most accurate method but requires more time and precision than counting QRS complexes in 6 seconds.

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The nurse is caring for a client diagnosed with acute heart failure on the telemetry unit. Which laboratory result does the nurse know is most indicative of this diagnosis?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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