A 66-year-old woman presents to the nurse practitioner with complaints of dyspnea, syncope, and palpitations. She believes she is having anxiety, but she has no history of mental health issues and is undergoing no major stressors. Which findings on physical exam would lead the NP to suspect atrial fibrillation?
Pulse rate of 157
Blood pressure of 93/62 mm Hg
Pulse rate of 43
Blood pressure of 149/94 mm Hg
The Correct Answer is A
Choice A reason: Atrial fibrillation typically presents with a rapid and irregular heartbeat. A pulse rate of 157 beats per minute is tachycardic and may indicate AF, especially in the context of palpitations, dyspnea, and syncope.
Choice B reason: Low blood pressure may be associated with multiple cardiac conditions but is not specific for AF.
Choice C reason: Bradycardia is generally not associated with typical atrial fibrillation unless there is a conduction defect or medication effect.
Choice D reason: Elevated blood pressure alone is not diagnostic of atrial fibrillation. It may be a chronic condition or a comorbidity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Referral to an oncologist is premature without diagnostic confirmation of malignancy.
Choice B reason: CA-125 is mainly used for ovarian cancer, which is unlikely after bilateral oophorectomy.
Choice C reason: Pap smear screens for cervical cancer and is not indicated for evaluating postmenopausal or post-oophorectomy bleeding.
Choice D reason: Correct. Endometrial biopsy or transvaginal ultrasound helps evaluate uterine pathology, including endometrial cancer, and is the most appropriate initial diagnostic step.
Correct Answer is C
Explanation
Choice A reason: Avoiding sick contacts is important for infection prevention, but low platelet count primarily increases bleeding risk, not infection risk.
Choice B reason: Aspirin inhibits platelet function and is contraindicated in severe thrombocytopenia, making this statement unsafe.
Choice C reason: This is correct. Patients with very low platelet counts are at high risk of bleeding; avoiding activities that could cause trauma reduces the risk of serious hemorrhage.
Choice D reason: While rest is beneficial, stopping work and sleeping excessively does not address the primary danger of thrombocytopenia, which is bleeding risk.
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