A nurse is assessing a client who has pericarditis. Which of the following findings is the priority?
Dependent edema
Pericardial friction rub
Paradoxical pulse
Substernal chest pain
The Correct Answer is C
A. Dependent edema can occur with pericarditis but does not indicate an immediate life-threatening complication.
B. A pericardial friction rub is a common finding in pericarditis and helps confirm the diagnosis but is not the priority.
C. A paradoxical pulse (an exaggerated decrease in systolic blood pressure during inspiration) is a sign of cardiac tamponade, a life-threatening complication of pericarditis, and requires immediate intervention.
D. Substernal chest pain is expected with pericarditis and is usually relieved by sitting up and leaning forward, but it is not the most urgent concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Shingles is not contagious; it is caused by the reactivation of the varicella-zoster virus.
B. HIV is not transmitted through routine patient care; universal precautions should be taken.
C. Tuberculosis is an infectious disease that poses a risk to pregnant individuals, so it's best for the pregnant nurse to avoid exposure.
D. Alcoholic pancreatitis and impetigo are not infectious diseases and do not pose a risk of transmission to the pregnant nurse.
Correct Answer is A
Explanation
A.
A. It's important to include the complete name of the medication to ensure clarity and accuracy in documentation.
B. Omitting the leading zero before a decimal point can lead to medication errors, so it's important to include it.
C. "U" is commonly used to denote units when documenting insulin dosage, so this statement is accurate.
D. "QOD" is an outdated abbreviation and can lead to confusion, so it should not be used; instead, "every other day" should be written out for clarity.
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