A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Cardiogenic shock

Left ventricular failure

Hypotension

Hypovolemia

Answer and Explanation

The Correct Answer is B

Choice A reason: Cardiogenic shock involves reduced cardiac output, typically with low PAWP due to decreased preload from poor heart function. Elevated PAWP reflects left atrial pressure buildup, not characteristic of cardiogenic shock alone, which is distinct from heart failure, requiring specific hemodynamic management.
Choice B reason: Elevated PAWP indicates left ventricular failure, where the heart cannot pump blood effectively, causing pulmonary congestion. This increases left atrial pressure, leading to pulmonary edema, a hallmark of heart failure. Diuretics and inotropes are needed to reduce fluid overload and improve cardiac function.
Choice C reason: Hypotension is a symptom, not a direct complication of elevated PAWP. It may occur in heart failure due to reduced cardiac output, but elevated PAWP specifically signals left heart dysfunction, not hypotension itself, which is a systemic response rather than a primary cardiac issue.
Choice D reason: Hypovolemia reduces blood volume, lowering PAWP due to decreased preload. Elevated PAWP suggests fluid overload or left ventricular dysfunction, not hypovolemia, which presents with low central venous pressure and dehydration signs, requiring fluid resuscitation rather than management of heart failure.

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Correct Answer is B

Explanation

Choice A reason: An HbA1c of 7.2% in type 1 diabetes indicates suboptimal control but is not an acute emergency. This client requires follow-up but is stable compared to life-threatening conditions, so they are not require immediate assessment, making this incorrect for prioritization.
Choice B reason: New-onset tachypnea in a hip fracture client suggests a life-threatening issue like pulmonary embolism, a common complication due to immobility. This requires immediate assessment to ensure airway and circulatory stability, aligning with ABC priorities, making it the correct first action for the nurse to take.
Choice C reason: Sinus arrhythmia is typically benign, especially with cardiac monitoring in place. It does not indicate an immediate threat compared to respiratory distress, so this client can be assessed later, making this incorrect for first priority assessment.
Choice D reason: Chest pain in a hypertensive client is concerning for cardiac issues, but tachypnea in a hip fracture suggests a more acute, potentially fatal condition like pulmonary embolism. Respiratory distress takes precedence, so this is incorrect for immediate assessment.

A. Tell her not to worry about it right now. B. You sound like you have questions about your mom dying. Let’s talk about it. C. Let’s talk about your mom’s cancer and what it means. D. Encourage her to focus on the present and not think about dying.

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

Explanation

Choice A reason: Telling the daughter not to worry dismisses her emotional concerns and does not facilitate open communication. Addressing fears about a loved one’s death requires empathy and discussion to process grief and understand hospice care, which focuses on comfort. This response is inappropriate, as it avoids addressing the daughter’s needs.
Choice B reason: Acknowledging the daughter’s concerns about her mother’s death and inviting discussion is therapeutic. It validates her emotions, encouraging open dialogue about grief, hospice care, and end-of-life expectations. This approach supports psychological coping, aligns with palliative care principles, and helps the daughter prepare for her mother’s transition, making it appropriate.
Choice C reason: Discussing the mother’s cancer and its implications helps the daughter understand the disease progression and hospice care’s role in symptom management. This fosters informed communication, addressing fears and clarifying expectations. It supports emotional preparation for end-of-life discussions, making this response appropriate for facilitating understanding and coping.
Choice D reason: Encouraging the daughter to avoid thinking about dying dismisses the reality of the situation and hinders emotional processing. Hospice care involves preparing for end-of-life, and open discussions about death are therapeutic. This response is inappropriate, as it discourages necessary conversations about the mother’s condition and prognosis.

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A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

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Naxlex Comprehensive Predictor Exams

A nurse is receiving change-of-shift report for a group of clients. Which of the following clients should the nurse plan to assess first?

Correct Answer is B

Explanation

A nurse is caring for a client who has cancer and is being transferred to hospice care. The client’s daughter tells the nurse, “I’m not sure what to say to my mom if she asks me about dying.” Which of the following responses by the nurse is appropriate? (Select all that apply)

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

Explanation

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