A nurse is assessing clients on a medical-surgical unit. Which client would the nurse identify as being at greatest risk for atrial fibrillation?

An 80-year-old with chronic obstructive pulmonary disease.

A 78-year-old who had a carotid endarterectomy.

A 45-year-old who takes an aspirin daily.

A 50-year-old who is post coronary artery bypass graft surgery.

Answer and Explanation

The Correct Answer is A

A. Atrial fibrillation (AF) is more common in older adults, particularly those with underlying conditions like chronic obstructive pulmonary disease (COPD). COPD can lead to structural changes in the heart, increasing the risk of AF. The elderly are particularly vulnerable due to age-related heart changes and comorbidities such as lung disease.

B. While carotid endarterectomy is a surgical procedure that can be related to stroke prevention, it is not directly associated with a higher risk of AF compared to COPD.

C. Aspirin is used for its antiplatelet effects, not directly related to the risk of AF.

D. Post coronary artery bypass graft (CABG) surgery increases the risk for arrhythmias, but it is less directly linked to AF than conditions like COPD in an older adult.

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Correct Answer is B

Explanation

A. Administering oxygen is unnecessary at this time, as the client’s oxygen saturation is normal at 96%.

B. The client has had a myocardial infarction, which can lead to complications such as orthostatic hypotension or cardiovascular strain with sudden position changes. A bedside commode minimizes the need for the client to get out of bed and reduces the risk of these complications.

C. Suggesting the use of a bedpan may be an alternative but is less comfortable and may not adequately address the risk of strain from getting out of bed.

D. Allowing continued bathroom privileges may be unsafe, as it may increase the risk of a fall or cardiovascular strain.

A. Assess the client's respiratory status. B. Ask the client about current medications. C. Administer intravenous furosemide. D. Draw blood to assess the client's serum electrolytes.

Correct Answer is A

Explanation

A. Assessing respiratory status is the priority in heart failure exacerbation, as respiratory distress can rapidly worsen and affect oxygenation.

B. While knowing current medications is important, the priority in this situation is addressing the client's respiratory needs.

C. Administering furosemide is part of the management plan but should follow the initial assessment of the client's condition, especially respiratory status.

D. Drawing blood is helpful but not the immediate priority in managing acute heart failure exacerbation.

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A nurse is assessing clients on a medical-surgical unit. Which client would the nurse identify as being at greatest risk for atrial fibrillation?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

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Correct Answer is A

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