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 D

Explanation

A. "Opioid narcotics are restricted for the client because of the risk for addiction":
This statement is not accurate and may contribute to unnecessary fear or misunderstanding about opioid use. While there is a risk of opioid addiction, it is generally low when opioids are used appropriately for pain management, especially in end-of-life care settings where the focus is on comfort and symptom management.

B. "Using opioid narcotics will limit options available for future management of pain":
This statement is misleading and may cause unnecessary concern. In end-of-life care, the priority is to provide effective pain relief and maximize comfort for the client. Opioid narcotics are an essential component of pain management in palliative and hospice care and do not necessarily limit future pain management options.

C. "The use of opioid narcotics is restricted to when death is imminent":
This statement is not accurate. Opioid narcotics can be used for pain management at various stages of illness, including but not limited to end-of-life care. While opioids are commonly used in palliative and hospice care settings, they may also be indicated for pain management in other clinical contexts.

D. "The dosage of the opioid narcotic is unlimited":
This statement is the most appropriate response. In end-of-life care, the goal of pain management is to relieve suffering and maximize comfort. Opioid dosages are titrated based on the client's pain intensity and response, and there is no strict limit to the dosage if needed to achieve adequate pain control. The priority is to ensure that the client is comfortable and free from pain as much as possible, even if higher doses of opioids are required.

A. S3 heart sounds B. Irregular pulsations C. Bradycardia D. Increase in point of maximum impulse (PMI)

Correct Answer is B

Explanation

A) S3 heart sounds:
S3 heart sounds are typically associated with heart failure and are not directly related to premature ventricular contractions (PVCs). S3 heart sounds occur during the early diastolic phase and are heard immediately after S2.

B) Irregular pulsations:
This is the correct choice. Premature ventricular contractions (PVCs) can cause irregular pulsations in the pulse. PVCs are premature contractions originating from the ventricles, which can interrupt the normal rhythm of the heart and lead to irregularities in the pulse.

C) Bradycardia:
Premature ventricular contractions (PVCs) can lead to various rhythm disturbances, but bradycardia (slow heart rate) is not typically associated with PVCs. In fact, PVCs often occur in the context of tachycardia (rapid heart rate).

D) Increase in point of maximum impulse (PMI):
An increase in the point of maximum impulse (PMI) is not typically associated with premature ventricular contractions (PVCs). The PMI refers to the location where the apex of the heart is palpated during systole and is not directly affected by PVCs.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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