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A 59-year-old client is brought into the emergency room with complaints of chest pain. The client states that the pain is a crushing, constrictive pressure that is not relieved with position change. He states that the pain started 3 hours ago in the middle of his chest and radiates down his left arm. The client has a history of diabetes, asthma, and hypertension.

T: 99

BP: 138/72

HR: 106

RR: 19

ECG-ST segment depression

Troponin - Negative

The client is given medication for his unstable angina. Soon after, the client states that he is having difficulty breathing with audible wheezing heard on auscultation. Which of the following is most likely responsible for the symptoms experienced by this client?

Heparin

Morphine

Propranolol

Nitroglycerin

Answer: C

Answer and Explanation

The Correct Answer is C

A. Heparin is an anticoagulant and does not typically cause bronchospasm or wheezing.

B. Morphine can cause respiratory depression but not bronchospasm.

C. Propranolol, a non-selective beta-blocker, can cause bronchospasm, particularly in clients with asthma.

D. Nitroglycerin primarily causes vasodilation and does not typically lead to bronchospasm or wheezing.

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Correct Answer is D

Explanation

A. Testing the equipment with a smaller shock is unnecessary when preparing to defibrillate in an emergency.

B. Epinephrine is used in cases of cardiac arrest with no pulse, particularly in asystole or pulseless electrical activity (PEA), not immediately before defibrillation in ventricular fibrillation.

C. Synchronous mode is used for cardioversion, not for defibrillation. Defibrillation should be delivered in unsynchronized mode.

D. Before delivering a shock, it is essential to ensure that everyone, including the nurse, is clear of the client and any conductive surfaces like the bed. This prevents injury from the electrical shock.

A. Early menarche B. Age greater than 65 years C. Genetic factors D. History of multiple births

Correct Answer is ["A","B","C"]

Explanation

A. Early menarche increases lifetime exposure to estrogen, raising breast cancer risk.

B. Age is a significant risk factor for breast cancer.

C. Genetic factors, like BRCA mutations, increase the risk.

D. History of multiple births is generally protective against breast cancer.

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Naxlex Comprehensive Predictor Exams

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?

Correct Answer is D

Explanation

The nurse is taking a history of a 68-year-old woman. What assessment findings would indicate a high risk for the development of breast cancer? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

The nurse assesses a client who just returned to the recovery area after undergoing a balloon angioplasty to improve circulation to the left leg. What assessment finding is the most concerning?

The health care provider orders: Epinephrine 0.25 mg IV stat Pharmacy provides: Epinephrine 0.1 mg/mL. How many mL will the nurse prepare to administer? (Round to one decimal place.)

The nurse observes the following EKG. Which lab would the nurse correlate with this finding?

A 36-yr-old client who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?

A client who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?

A client who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the client is on which medication?

A client who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine levels. Which prescribed therapy should the nurse implement first?

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?