The nurse is monitoring a 53-year-old client who is undergoing a cardiac exercise stress test after experiencing an episode of angina. Which client finding will require the test to be discontinued?

Heart rate of 134 bpm

Mild shortness of breath

Three premature ventricular contractions in a row

Blood pressure 152/88 mmHg

Answer and Explanation

The Correct Answer is C

A. Heart rate of 134 bpm. A heart rate of 134 bpm is expected during a cardiac stress test, as the goal is to increase the heart rate to a target range to evaluate cardiac function under stress.

B. Mild shortness of breath. Mild shortness of breath is a common response to exercise and is not an indication to stop the test unless it becomes severe or is accompanied by other concerning symptoms like chest pain or cyanosis.

C. Three premature ventricular contractions in a row indicate a potential serious arrhythmia (ventricular tachycardia), which is a contraindication for continuing the stress test. This finding could place the client at risk for life-threatening cardiac events, such as ventricular fibrillation.

D. Blood pressure 152/88 mmHg. This is a slightly elevated but normal physiological response to exercise and does not warrant discontinuation of the test unless the blood pressure rises to dangerously high levels (e.g., >200/110 mmHg).

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Correct Answer is B

Explanation

A. Complete (third-degree) heart block: This rhythm is characterized by a lack of relationship between P waves and QRS complexes, indicating a complete dissociation between atrial and ventricular activity.

B. A pacemaker rhythm on an ECG is characterized by the presence of pacing spikes followed by P waves or QRS complexes, depending on whether the pacemaker is pacing the atrium or the ventricle. If the pacemaker is pacing the ventricle, the pacing spike will be followed by a QRS complex. The QRS complexes in a paced rhythm are often wider than normal.

C. Sinus bradycardia: Sinus bradycardia is a slow but regular rhythm originating from the sinus node, with normal P waves and QRS complexes.

D. First-degree heart block: First-degree heart block is characterized by a prolonged PR interval (greater than 0.20 seconds) but with all P waves followed by QRS complexes, differing from third-degree heart block.

A. The client's blood pressure has decreased since the last visit B. The client's liver is enlarged and the abdomen is edematous C. The client has jugular vein distention and 3+ pedal edema D. The client complains of shortness of breath when walking

Correct Answer is D

Explanation

A. The client's blood pressure has decreased since the last visit. Decreased blood pressure is not a typical early sign of mitral valve stenosis.

B. The client's liver is enlarged and the abdomen is edematous. These are signs of more advanced heart failure, which can result from mitral valve stenosis but are not early indicators.

C. The client has jugular vein distention and 3+ pedal edema. Jugular vein distention and pedal edema are later signs of heart failure caused by mitral valve stenosis, not early signs.

D. The client complains of shortness of breath when walking. Shortness of breath on exertion is an early sign of mitral valve stenosis as the left atrium is unable to effectively pump blood into the left ventricle, leading to pulmonary congestion and difficulty breathing.

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The nurse is monitoring a 53-year-old client who is undergoing a cardiac exercise stress test after experiencing an episode of angina. Which client finding will require the test to be discontinued?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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