A nurse is collecting data from a client who is receiving continuous cardiac monitoring that is indicating premature ventricular contractions (PVCs). Which of the following findings should the nurse expect when assessing the client?

S3 heart sounds

Irregular pulsations

Bradycardia

Increase in point of maximum impulse (PMI)

Answer and Explanation

The Correct Answer is B

A) S3 heart sounds:
S3 heart sounds are typically associated with heart failure and are not directly related to premature ventricular contractions (PVCs). S3 heart sounds occur during the early diastolic phase and are heard immediately after S2.

B) Irregular pulsations:
This is the correct choice. Premature ventricular contractions (PVCs) can cause irregular pulsations in the pulse. PVCs are premature contractions originating from the ventricles, which can interrupt the normal rhythm of the heart and lead to irregularities in the pulse.

C) Bradycardia:
Premature ventricular contractions (PVCs) can lead to various rhythm disturbances, but bradycardia (slow heart rate) is not typically associated with PVCs. In fact, PVCs often occur in the context of tachycardia (rapid heart rate).

D) Increase in point of maximum impulse (PMI):
An increase in the point of maximum impulse (PMI) is not typically associated with premature ventricular contractions (PVCs). The PMI refers to the location where the apex of the heart is palpated during systole and is not directly affected by PVCs.

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Correct Answer is D

Explanation

(A) Increased bowel sounds
At the end of life, decreased bowel sounds or even absent bowel sounds are more common due to reduced gastrointestinal activity as the body begins to shut down. Increased bowel sounds are not typically expected.

(B) Hypertension
Hypertension is not typically expected at the end of life. Instead, hypotension (low blood pressure) is more common as the heart and other systems begin to fail.

(C) Moist mucous membranes
At the end of life, mucous membranes are often dry due to decreased fluid intake and systemic dehydration. Moist mucous membranes would not be an expected finding.

(D) Mottled skin
Mottled skin is a common and expected finding at the end of life. It occurs as circulation diminishes and the skin takes on a blotchy, purplish appearance, typically starting in the extremities and moving centrally. This is a sign that the body is shutting down and approaching death.

A. A patient with coronary artery disease (CAD) who reports chest pain radiating to the jaw. B. A patient with venous insufficiency with 2+ pitting edema. C. A patient receiving enoxaparin (Lovenox) for experiencing an MI 3 days ago. D. A patient with peripheral artery disease (PAD) with a diminished pulse.

Correct Answer is A

Explanation

A. A patient with coronary artery disease (CAD) who reports chest pain radiating to the jaw: This patient should be evaluated first. Chest pain radiating to the jaw can be a sign of a heart attack, which is a life-threatening condition. Immediate medical attention is required to prevent further damage to the heart muscle.

B. A patient with venous insufficiency with 2+ pitting edema: While this patient’s condition needs to be addressed, it is not as immediately life-threatening as a potential heart attack. Venous insufficiency and edema can lead to discomfort and complications if left untreated, but these complications are typically not immediate.

C. A patient receiving enoxaparin (Lovenox) for experiencing an MI 3 days ago: This patient is already receiving treatment for their condition. While they should be monitored for side effects of the medication and signs of further cardiac issues, they are not the highest priority based on the information given.

D. A patient with peripheral artery disease (PAD) with a diminished pulse: While a diminished pulse can indicate poor blood flow, which can lead to complications such as tissue damage and non-healing wounds, it is not as immediately life-threatening as a potential heart attack. This patient should be evaluated, but they are not the highest priority based on the information given.

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A nurse is collecting data from a client who is receiving continuous cardiac monitoring that is indicating premature ventricular contractions (PVCs). Which of the following findings should the nurse expect when assessing the client?

Nursing Test Bank

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