The nurse is caring for a group of patients. Which of the the following patients should the nurse evaluate first?

A patient with coronary artery disease (CAD) who reports chest pain radiating to the jaw.

A patient with venous insufficiency with 2+ pitting edema.

A patient receiving enoxaparin (Lovenox) for experiencing an MI 3 days ago.

A patient with peripheral artery disease (PAD) with a diminished pulse.

Answer and Explanation

The Correct Answer is A

A. A patient with coronary artery disease (CAD) who reports chest pain radiating to the jaw: This patient should be evaluated first. Chest pain radiating to the jaw can be a sign of a heart attack, which is a life-threatening condition. Immediate medical attention is required to prevent further damage to the heart muscle.

B. A patient with venous insufficiency with 2+ pitting edema: While this patient’s condition needs to be addressed, it is not as immediately life-threatening as a potential heart attack. Venous insufficiency and edema can lead to discomfort and complications if left untreated, but these complications are typically not immediate.

C. A patient receiving enoxaparin (Lovenox) for experiencing an MI 3 days ago: This patient is already receiving treatment for their condition. While they should be monitored for side effects of the medication and signs of further cardiac issues, they are not the highest priority based on the information given.

D. A patient with peripheral artery disease (PAD) with a diminished pulse: While a diminished pulse can indicate poor blood flow, which can lead to complications such as tissue damage and non-healing wounds, it is not as immediately life-threatening as a potential heart attack. This patient should be evaluated, but they are not the highest priority based on the information given.

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Correct Answer is B

Explanation

(A) Bradycardia: Bradycardia, or a slower than normal heart rate, is not typically associated with metabolic acidosis. Metabolic acidosis often leads to an increased heart rate (tachycardia) as the body tries to compensate for the acid-base imbalance.

(B) Hyperventilation: This is the most appropriate answer. Hyperventilation is a common response to metabolic acidosis. The body attempts to compensate for the high acid levels by increasing the rate and depth of breathing to expel more carbon dioxide (which is acidic) and raise the blood pH.

(C) Increased blood pressure: Metabolic acidosis does not typically cause an increase in blood pressure. In fact, severe acidosis can lead to vasodilation and a decrease in blood pressure.

(D) Cool, clammy skin: While cool, clammy skin can be a sign of shock or other serious conditions, it is not a typical manifestation of metabolic acidosis. However, in severe cases, metabolic acidosis can lead to shock, which might present with cool, clammy skin.

A. Swallow the tablet whole with an 8 oz glass of water. B. Store the medication in a pill box at the bedside. C. Take the medication at the first indication of chest pain. D. Remove the nitroglycerine patch before taking the sublingual tablet.

Correct Answer is C

Explanation

(A) Swallow the tablet whole with an 8 oz glass of water.
Sublingual nitroglycerin tablets should not be swallowed. They need to be placed under the tongue where they can dissolve and be absorbed quickly to provide rapid relief from angina.

(B) Store the medication in a pill box at the bedside.
Nitroglycerin sublingual tablets should be stored in their original container and kept tightly closed to protect them from light and moisture. Storing them in a pill box at the bedside could lead to degradation of the medication.

(C) Take the medication at the first indication of chest pain.
This is the correct instruction. Nitroglycerin sublingual tablets should be taken at the first sign of chest pain to provide prompt relief. The rapid onset of action helps to alleviate angina symptoms quickly.

(D) Remove the nitroglycerine patch before taking the sublingual tablet.
It is not necessary to remove the nitroglycerin patch before taking a sublingual tablet. The two forms of nitroglycerin can be used together, as the patch provides a continuous dose while the sublingual tablet offers rapid relief of acute symptoms.

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The nurse is caring for a group of patients. Which of the the following patients should the nurse evaluate first?

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Naxlex Comprehensive Predictor Exams

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