A nurse is checking for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

Apical pulse rate different than the radial pulse rate

Increase in heart rate by 20% when standing

Drop in systolic BP by 20 mm Hg when moving from a lying to a sitting position

Drop in systolic BP more than 10 mm Hg on inspiration

Answer and Explanation

The Correct Answer is D

Choice A reason: An apical pulse rate different than the radial pulse rate is known as a pulse deficit, which can indicate atrial fibrillation or other cardiac arrhythmias, but it is not related to paradoxical blood pressure or constrictive pericarditis.

Choice B reason: An increase in heart rate by 20% when standing is indicative of orthostatic hypotension, not paradoxical blood pressure. This condition involves a drop in blood pressure upon standing, leading to a compensatory increase in heart rate.

Choice C reason: A drop in systolic BP by 20 mm Hg when moving from a lying to a sitting position is another indicator of orthostatic hypotension, not paradoxical blood pressure.

Choice D reason: The correct answer is d because a drop in systolic BP of more than 10 mm Hg on inspiration, known as pulsus paradoxus, is a characteristic finding in constrictive pericarditis. This occurs due to the impaired filling of the heart during inspiration, leading to a significant drop in systolic blood pressure.

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Correct Answer is B

Explanation

Choice A reason: A blood pressure of 134/82 mm Hg is within the normal range and typically does not require immediate intervention. It is important to monitor blood pressure trends, but this value alone is not concerning.

Choice B reason: The correct answer is b because headache and restlessness can be signs of dialysis-related complications such as disequilibrium syndrome or fluid and electrolyte imbalances. These symptoms should be reported to the provider for further evaluation and management.

Choice C reason: A palpable thrill at the AV fistula access site indicates that the fistula is functioning properly. This is an expected finding and does not require intervention.

Choice D reason: A heart rate of 65 bpm is within the normal range for most adults and does not typically require immediate intervention unless associated with other symptoms or abnormalities.

A. "You shouldn't feel any pain since the local area is anesthetized." B. "Most clients report more discomfort from the preparation than from the procedure itself." C. "You may feel some cramping during the procedure." D. "Don't worry; you won't remember anything about the procedure due to the effects of the medication."

Correct Answer is C

Explanation

Choice A reason: Local anesthesia is not typically used for a colonoscopy. Sedation and analgesia are used to make the client comfortable, but some sensation may still be felt.

Choice B reason: While it is true that many clients find the bowel preparation uncomfortable, this statement does not address the client's concern about pain during the procedure itself.

Choice C reason: The correct answer is c because it is honest and informative. Clients may experience some cramping during a colonoscopy, but it is usually mild and can be managed with sedation and analgesia.

Choice D reason: This statement may be reassuring but is not entirely accurate. While sedation may cause some amnesia, it is important to provide realistic expectations about the procedure and potential sensations.

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A nurse is checking for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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