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A nurse is caring for a client diagnosed with atrial fibrillation and is receiving heparin. Which of the following findings is the nurse's priority?

The client experiences sudden weakness of one arm and leg

The client's ECG tracing shows irregular heart rate without P waves.

The client's urine output is cloudy and odorous.

The client has an aPTT of 80 seconds.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Sudden weakness of one arm and leg may indicate a stroke, which is a potential complication of atrial fibrillation.

B. An irregular heart rate without P waves is characteristic of atrial fibrillation and is expected.

C. Cloudy and odorous urine may indicate a urinary tract infection but is not the priority in this case.

D. An aPTT of 80 seconds is within the therapeutic range for heparin therapy.

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Correct Answer is B

Explanation

Rationale:

A. Taking a diuretic before sleep and drinking fluids during the day is important but does not specifically address sodium intake.

B. This statement indicates an understanding of the importance of limiting sodium intake, which is crucial in managing congestive heart failure.

C. Pacing activities is important but is not specific to sodium intake.

D. Naproxen is not typically used to manage discomfort in congestive heart failure.

A. "The test is used to assess the structures and function of the valves and heart muscle" B. "You will not be permitted to eat or drink after midnight C. "During the test there will be slight discomfort in the chest area" D. "The test is used to identify the extent of blockages in the arteries in the heart

Correct Answer is A

Explanation

Rationale:

A. An echocardiogram is a diagnostic test that uses sound waves to create images of the heart's chambers, valves, and surrounding structures, and assesses their function.

B. Fasting is not typically required for an echocardiogram.

C. Discomfort is not typically associated with an echocardiogram.

D. An echocardiogram does not typically assess the extent of blockages in the arteries.

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A nurse is caring for a client diagnosed with atrial fibrillation and is receiving heparin. Which of the following findings is the nurse's priority?

Nursing Test Bank

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