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A nurse is caring for a heart failure client with a history of dietary non compliance. The nurse suspects the client has fluid volume overload. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY))

Increased blood pressure

increased heart rate

Increase hematocrit

Increased respiratory rate

Increased temperature

Answer and Explanation

Correct Answer : A,B,D

Rationale:

A. Fluid overload can lead to increased blood pressure due to the excess fluid circulating in the body.

B. Increased heart rate is a compensatory mechanism in response to fluid volume overload.

C. Increased hematocrit is not typically associated with fluid volume overload.

D. Increased respiratory rate is a compensatory mechanism in response to fluid volume overload.

E. Increased temperature is not typically associated with fluid volume overload.

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Correct Answer is D

Explanation

Rationale:

A. Hypertensive crisis is not a common complication of atrial fibrillation.

B. Cardiogenic shock is not a common complication of atrial fibrillation.

C. Flash pulmonary edema is not a common complication of atrial fibrillation.

D. Atrial fibrillation can lead to the formation of blood clots in the atria, which can then travel to the brain and cause a stroke or embolic cerebral vascular accident.

A. Petechiae B. Slowing pulse rate C. Confusion D. Pruritus

Correct Answer is A

Explanation

Rationale:

A. Petechiae are small, pinpoint red or purple spots on the skin that may indicate bleeding or thrombocytopenia, which can be a side effect of heparin therapy.

B. Slowing pulse rate is not typically associated with heparin therapy.

C. Confusion is not typically associated with heparin therapy.

D. Pruritus (itching) is not typically associated with heparin therapy.

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A nurse is caring for a heart failure client with a history of dietary non compliance. The nurse suspects the client has fluid volume overload. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY))

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with heart failure (HF) and atrial fibrillation. The client reports feeling of palpitations and shortness of breath. The nurse is aware that clients Atrial Fibrillation (AF) are at risk for which complication?

Correct Answer is D

Explanation

A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Correct Answer is A

Explanation

A nurse is caring for a client post cardiac catheterization via the right groin site. The nurse is aware that which of the following findings needs to be reported to the interventional cardiologist as soon as it is identified.

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A nurse is caring for a heart failure client with a history of dietary non compliance. The nurse suspects the client has fluid volume overload. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY))

A nurse is caring for a client who is having an acute myocardial infarction (MI). The nurse is aware that which of the following are part of the assessment of cardiac pain. (SELECT ALL THAT APPLY)

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A nurse is caring for a client with a possible acute myocardial infarction (AMI). The electrocardiogram (ECG) shows no ST segment elevations or depression. The nurse is aware that an elevation of which lab result will determine if there has been cardiac injury?