While admitting an 82-year-old with acute decompensated heart failure to the hospital, the nurse learns that the client lives alone and sometimes confuses the "water pill" with the "heart pill." When planning for the client's discharge the nurse will facilitate a

transfer to a long-term care facility.

arrangements for around-the-clock care.

consult with a psychologist.

referral to a home health care agency.

Answer and Explanation

The Correct Answer is D

A. Transfer to a long-term care facility is not necessary unless the client is unable to live independently despite support.
B. Around-the-clock care is excessive for a client who can still live alone and just needs assistance with medication management.
C. A psychologist is not the appropriate referral unless there are clear signs of mental health issues.
D. Referral to a home health care agency is appropriate to support the client at home, provide medication education, monitor adherence, and reduce the risk of readmission due to medication errors.

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Correct Answer is C

Explanation

A. A client showing signs of shock (e.g., cold, clammy skin, decreased bowel sounds, tachycardia) is not likely to stabilize and be released by the next day without intensive treatment.
B. The irreversible stage of shock is marked by profound hypotension, multi-organ failure, and unresponsiveness—more severe than this client’s current status.
C. The progressive stage of shock is characterized by impaired tissue perfusion, cold and clammy skin, tachycardia, hypoactive bowel sounds, and early signs of organ dysfunction. Even though the blood pressure is currently normal, perfusion is inadequate.
D. The compensatory stage is earlier and includes signs like tachycardia and restlessness, but perfusion to vital organs is still maintained, and skin may remain warm. This client’s cold skin and decreased bowel sounds suggest progression beyond this stage.

A. Heart failure B. Pulmonary embolism C. Tension pneumothorax D. Cardiac tamponade

Correct Answer is A

Explanation

A. Heart failure often presents with dyspnea, crackles (from pulmonary congestion), jugular vein distention, dependent edema, and hepatomegaly due to fluid overload and impaired cardiac output—these are classic signs.
B. Pulmonary embolism typically causes sudden dyspnea, chest pain, and tachypnea but not hepatomegaly or dependent edema.
C. Tension pneumothorax presents with tracheal deviation, absent breath sounds on one side, and hypotension—different from the systemic fluid overload signs described.
D. Cardiac tamponade presents with muffled heart sounds, hypotension, and jugular vein distention (Beck's triad), but it does not cause crackles, hepatomegaly, or peripheral edema.

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While admitting an 82-year-old with acute decompensated heart failure to the hospital, the nurse learns that the client lives alone and sometimes confuses the "water pill" with the "heart pill." When planning for the client's discharge the nurse will facilitate a

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Naxlex Comprehensive Predictor Exams

A 57-year-old-client is being admitted to the intensive care unit (ICU) with a diagnosis of possible septic shock He has a normal blood pressure, increased heart rate, decreased bowel sounds, and their skin is cold and clammy. The ICU nurse suspects the client:

Correct Answer is C

Explanation

The nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect?

Correct Answer is A

Explanation

A nurse is assessing an ECG rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second. The overall heart rate is 60 beats/min. The nurse assesses the cardiac rhythm as:

A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?

The nurse is teaching a beginning ECG class to staff nurses. As the nurse begins to discuss the parts of the ECG complex, one of the students asks what the normal order of conduction through the heart is. The correct response would be which of the following?

The nurse discussing potential risk factors of infective endocarditis with a hospitalized client would include which of the following as a potential risk factor of this disease process?

A nurse assessing a client determines they are in the compensatory stage of shock. Which of the following findings support this conclusion?

A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect?

The nurse who is caring for a client in ICU on a ventilator assesses a need for suctioning and is aware that the most common cardiac arrhythmia occurring during endotracheal suctioning is:

A nurse is admitting a client who has a history of heart failure. Exhibits Check the 3 findings that require immediate follow-up.