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The nurse is caring for a team of assigned clients. Which client is a priority for the nurse to check on first?

The client with a history of a myocardial infarction who has a p wave before every QRS complex.

The client diagnosed with heart failure who has bilateral 2+ pitting pedal edema.

The client with sinus bradycardia (HR 56/min) that is reporting fatigue.

The client diagnosed with coronary artery disease who is now reporting new onset of severe indigestion.

Answer and Explanation

The Correct Answer is D

A. The client with a history of a myocardial infarction who has a p wave before every QRS complex.

This may indicate a heart block, which requires attention. However, it's not an immediate life-threatening situation.

B. The client diagnosed with heart failure who has bilateral 2+ pitting pedal edema.

Bilateral pitting pedal edema is a sign of fluid overload, which is concerning and requires attention.

C. The client with sinus bradycardia (HR 56/min) that is reporting fatigue.

While bradycardia and fatigue are concerns, they might not be as urgent as the client with fluid overload.

D. The client diagnosed with coronary artery disease who is now reporting new onset of severe indigestion.

New onset of severe indigestion in a client with coronary artery disease raises concern for a potential cardiac event, and this should be addressed promptly.

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Correct Answer is D

Explanation

A. Coronary artery disease (CAD):

Coronary artery disease primarily affects the blood vessels supplying the heart muscle. Symptoms often include chest pain (angina) rather than pain in the lower extremities. The symptoms described in the scenario are not characteristic of CAD.

B. Arterial embolus:

An arterial embolus is a blood clot or debris that travels through the bloodstream and can block an artery. While it can cause decreased blood flow and pain, the presentation in the lower left leg and foot with relief of pain at rest is more suggestive of peripheral arterial disease (PAD) or intermittent claudication rather than an acute arterial embolus.

C. Raynaud disease:

Raynaud's disease is characterized by episodes of reduced blood flow to the extremities, usually triggered by cold or stress. It typically involves color changes (white, blue, red) in the fingers or toes. The symptoms described, including pain in the lower leg and foot during walking, are not typical of Raynaud's disease.

D. Intermittent claudication:

Intermittent claudication is a symptom associated with peripheral arterial disease (PAD). It involves pain or cramping in the legs during physical activity, such as walking, due to reduced blood flow to the muscles. Rest typically relieves the pain. The observation of a hairless leg and slight edema suggests potential vascular compromise in the lower extremity, supporting the diagnosis of intermittent claudication.

A. International normalized ratio (INR) B. Brain natriuric peptide (BNP) C. Troponin D. Creatinine

Correct Answer is B

Explanation

A. International normalized ratio (INR):

INR is a test used to monitor the effectiveness of anticoagulant therapy, particularly drugs like warfarin. It measures the time it takes for blood to clot. It's not directly related to assessing heart failure but is more associated with monitoring anticoagulation status.

B. Brain natriuretic peptide (BNP):

BNP is a peptide released by the heart in response to increased pressure and volume in the heart, often seen in heart failure. Elevated BNP levels can indicate the presence of heart failure. It's a useful diagnostic marker for heart failure.

C. Troponin:

Troponin is a protein released into the blood when there is damage to the heart muscle, usually during a heart attack. It is not specific to heart failure but is commonly used to diagnose myocardial infarction (heart attack).

D. Creatinine:

Creatinine is a waste product that comes from the normal wear and tear on muscles. While elevated creatinine levels can be seen in conditions affecting kidney function, it's not a direct marker for assessing heart failure. However, kidney function is often evaluated in conjunction with heart failure assessments.

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The nurse is caring for a team of assigned clients. Which client is a priority for the nurse to check on first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is taking health history for a client who reports pain in his lower left leg and foot when walking. The pain is relieved with rest, and the nurse observes the left leg is hairless and slightly edematous. The nurse recognizes this as which medical diagnosis or health problem?

Correct Answer is D

Explanation

The nurse is caring for a client who has signs and symptoms of heart failure. Which of the following diagnostic tests is appropriate to assess the patient’s heart failure?

Correct Answer is B

Explanation

A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical complication. The nurse’s assessment reveals that the client has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the patient to do?

A client with severe nausea has a one time order for ondansetron (Zofran) 8 mg IVPB to be administered over 15 minutes. The medication is diluted in 50 mL of D5W. The tubing drop factor is 15 gtt/mL. How many drops per minute should be given?

The nurse is caring for a patient who has decreased mobility. Which intervention is a simple and cost-effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall expansion?

Which of the following does the nurse recognize is common in peripheral venous insufficiency?

The nurse is caring for a client who is undergoing an exercise stress test. Prior to reaching the target heart rate, the client develops chest pain. What is the nurse’s most appropriate interpretation of the chest pain?

The nurse is planning the care of a client with heart failure. The nurse should identify what overall goals for the client’s care? (SELECT ALL THAT APPLY)

The nurse is providing care for a client recently diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis?

An emergency department nurse is assessing an adult woman for a suspected myocardial infarction (MI). When planning the assessment, the nurse should be aware that female patients may have which of the following symptoms for an MI? (SELECT ALL THAT APPLY)