A client with new onset right-sided weakness is admitted to the emergency department and the following orders are received. Which order should the nurse implement first?
Aspirin 325mg po
Non-contrast computed tomography (CT) scan
Electrocardiogram (ECG)
Simvastatin (Zocor) 80 mg po
The Correct Answer is B
A. Aspirin 325 mg PO: Aspirin is important for preventing clot formation but should not be administered until a hemorrhagic stroke is ruled out.
B. Non-contrast computed tomography (CT) scan: This is the priority because it determines whether the stroke is ischemic or hemorrhagic, guiding further treatment.
C. Electrocardiogram (ECG): While assessing cardiac rhythm is important, it is not the immediate priority in the presence of stroke symptoms.
D. Simvastatin (Zocor) 80 mg PO: Statins are used for long-term management but are not urgent in this acute scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Suppresses ectopic ventricular sites: Atropine primarily increases heart rate; it does not directly suppress ectopic ventricular activity.
B. Increases SA node automaticity: Atropine blocks the parasympathetic nervous system, increasing SA node activity and heart rate in cases of bradycardia or asystole.
C. Increases myocardial contractility: This effect is more related to drugs like inotropes (e.g., dopamine), not atropine.
D. Decreases AV node conduction: Atropine actually increases conduction through the AV node by blocking vagal stimulation.
Correct Answer is C
Explanation
A. "It is an amino acid which reflects damage to the endothelial lining of arteries." BNP is not related to endothelial damage.
B. "It is a substance composed of free fatty acids reflective of atherosclerosis." BNP is not composed of free fatty acids, and it does not reflect atherosclerosis.
C. "It is a reliable indicator of the presence of heart failure." BNP is a hormone released by the heart in response to increased pressure and volume. Elevated levels of BNP are commonly used as a diagnostic marker for heart failure, especially during exacerbations or decompensation.
D. "It is a protein produced by the liver in response to systemic inflammation." BNP is produced by the heart, not the liver.
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