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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["125"]
Explanation
To calculate the amount of mL that the client should receive, we need to use the formula:
mL = (g * 5 mL) / mg
where g is the ordered dose of the medication, mg is the concentration of the medication, and mL is the volume of the solution.
Plugging in the given values, we get:
mL = (4 g * 5 mL) / 160 mg
Simplifying, we get:
mL = 0.125 g/mL
Multiplying by 1000 to convert grams to milligrams, we get:
mL = 125 mg/mL
Therefore, the client should receive 125 mL of the solution.
Correct Answer is A
Explanation
A. "The test will provide a detailed profile of the heart’s electrical activity."
This statement is inappropriate because transesophageal echocardiography (TEE) primarily provides detailed images of the heart's structure, such as the valves and chambers, rather than focusing on the heart's electrical activity. The assessment of electrical activity is typically associated with electrocardiography (ECG or EKG) rather than echocardiography.
B. "I will need to start an IV in your arm before the test."
This statement is appropriate. It is common for medical procedures, including TEE, to require an intravenous (IV) line for administration of medications or fluids during or after the procedure.
C. "Your throat may be a little sore after the exam."
This statement is appropriate. TEE involves inserting a probe through the esophagus, and it is common for patients to experience a sore throat afterward due to the presence of the probe.
D. "You will need to refrain from eating and drinking 6-8 hours before this test."
This statement is appropriate. It is standard practice to ask patients to fast for a specific period before TEE to minimize the risk of complications, such as aspiration, during the procedure.
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