A nurse in a provider's office is caring for a male client.

Exhibits

Drag words from the choices below to fill in each blank in the following sentence.

The nurse is evaluating the client's response to the prescribed medications. The client's
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and
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indicate an improvement in the client's condition.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Answer: The nurse is evaluating the client's response to the prescribed medications. The client's blood pressure and HDL level indicate an improvement in the client's condition.

Blood pressure: The client's blood pressure decreased from 180/88 mm Hg to 138/70 mm Hg, which indicates an effective response to atenolol, a betablocker used for hypertension management.

HDL level: The HDL ("good cholesterol") increased from 25 mg/dL to 60 mg/dL, reflecting a positive response to simvastatin, which helps improve lipid profiles and reduce cardiovascular risk.

Heart rate: The heart rate dropped from 96/min to 58/min, which may be due to atenolol. While bradycardia is a side effect, it is only concerning if it drops below 50/min.

Weight: The client gained 4 kg (8.8 lb), which may indicate fluid retention and requires further assessment.

Potassium level: The potassium level increased from 4.2 to 5.3 mEq/L, likely due to spironolactone, a potassiumsparing diuretic. This is above the normal range and requires monitoring for hyperkalemia.

Pedal findings: The edema worsened from 2+ to 3+, indicating fluid retention and possible worsening heart failure, requiring intervention.

Pulse oximetry: The oxygen saturation slightly decreased from 97% to 95%, but this is within normal limits and does not indicate a significant clinical improvement or deterioration.

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Correct Answer is C

Explanation

A. Differences in upper and lower lung sounds. While pericarditis may cause pleuritic chest pain and a pericardial friction rub, differences in lung sounds between upper and lower fields are more commonly associated with pulmonary conditions like pneumonia or pleural effusion rather than atrial fibrillation.
B. Differences between oral and axillary temperatures. Temperature discrepancies are not related to atrial fibrillation. Though pericarditis may be accompanied by fever due to inflammation, AF is primarily an electrical disturbance and does not directly impact body temperature regulation.
C. Different apical and radial pulses. A pulse deficit, where the apical pulse is higher than the radial pulse, is a hallmark sign of atrial fibrillation. This occurs because the irregular, rapid atrial contractions lead to some ventricular beats that are too weak to produce a palpable radial pulse, indicating ineffective cardiac output.
D. Different blood pressures in the upper limbs. Significant differences in blood pressure between the arms are more indicative of vascular conditions such as aortic dissection or subclavian artery stenosis rather than atrial fibrillation, which primarily affects heart rhythm rather than arterial perfusion.

A. The client should receive a diet with increased protein. B. The client has an increased risk for bleeding. C. The client has an increased risk of infection. D. The client should receive an erythropoiesis stimulating agent.

Correct Answer is C

Explanation

A. The client should receive a diet with increased protein. The client’s albumin level is normal (4.5 g/dL), indicating adequate protein levels. While maintaining good nutrition is important, there is no indication of protein deficiency requiring dietary modification.
B. The client has an increased risk for bleeding. The platelet count (170,000/mm³) is within normal limits (150,000–400,000/mm³), meaning the client is not at an increased risk for bleeding. However, close monitoring is necessary, as cisplatin can cause thrombocytopenia over time.
C. The client has an increased risk of infection. The WBC count is critically low (1,400/mm³, with normal being 4,000–11,000/mm³), indicating severe neutropenia. Cisplatin is a myelosuppressive chemotherapy agent that can cause bone marrow suppression, leading to neutropenia and an increased risk of lifethreatening infections. Clients with neutropenia should follow infection prevention precautions, including hand hygiene, avoiding crowds, and monitoring for fever (which may be the only sign of infection in neutropenic patients).
D. The client should receive an erythropoiesisstimulating agent. The hemoglobin (12.1 g/dL) and hematocrit (36.5%) are within normal limits, indicating that the client does not currently require erythropoiesisstimulating agents (e.g., epoetin alfa). These agents are only recommended for chemotherapyinduced anemia (Hgb <10 g/dL).

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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