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
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).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Bring the crash cart to the bedside: Essential for advanced cardiac life support (ACLS), including defibrillation and medications.
B. Start cardiopulmonary resuscitation: High-quality CPR is critical to maintain circulation until defibrillation can occur.
C. Defibrillate the client: Defibrillation is the definitive treatment for ventricular fibrillation to restore a normal rhythm.
D. Administer adenosine (Adenocard) to assist in determining the rhythm: Adenosine is used for diagnosing or treating certain supraventricular tachycardias, not ventricular fibrillation.
E. Consider the "Hs and Ts": Identifying reversible causes of cardiac arrest (e.g., hypoxia, hypothermia, toxins) is part of the ACLS protocol.
Correct Answer is B
Explanation
A. Urine glucose, high: High urine glucose would suggest hyperglycemia, typically seen in diabetes mellitus, not diabetes insipidus.
B. Urine specific gravity, 1.001: Diabetes insipidus results in excessive urine output with a low specific gravity (dilute urine), reflecting the inability to concentrate urine.
C. Urine output, 50 ml/hr: This is a relatively low urine output, which does not indicate diabetes insipidus. Diabetes insipidus is characterized by very high urine output, often greater than 3 liters per day.
D. Urine protein, high: High urine protein could suggest kidney disease or glomerular injury, not diabetes insipidus.
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