A nurse is collecting data on a client who has infective endocarditis. The nurse should recognize which of the following findings is the priority to report to the provider?
Malaise
Dyspnea
Fever
Anorexia
The Correct Answer is B
A. Malaise: Malaise is a common symptom of infective endocarditis, indicating generalized discomfort or fatigue. However, it is not an immediate life-threatening condition and does not require urgent intervention.
B. Dyspnea: Dyspnea is the priority because it can indicate heart failure or a pulmonary embolism, both of which are serious complications of infective endocarditis. This requires immediate attention and reporting.
C. Fever: Fever is common in infective endocarditis due to the underlying infection. While important, it is expected and usually managed with antipyretics and antibiotics. It is not as urgent as dyspnea.
D. Anorexia: Anorexia is also a common symptom of infective endocarditis but is not an immediate threat to the client’s health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Exercise ECG stress test: An exercise ECG stress test requires informed consent because it involves physical activity that may place stress on the heart and carries certain risks, such as inducing arrhythmias or other complications.
B. Electrocardiogram: An electrocardiogram (ECG or EKG) is a non-invasive, routine diagnostic test that does not require written informed consent.
C. CT scan without contrast dye: A CT scan without contrast dye is a standard imaging procedure that typically does not require written informed consent, unless there are specific risks or complications involved.
D. Echocardiogram: An echocardiogram is a non-invasive ultrasound test of the heart and does not require written informed consent under normal circumstances.
Correct Answer is D
Explanation
A. Nitroglycerin: Nitroglycerin is used to relieve chest pain by dilating coronary arteries and increasing blood flow. However, in the immediate setting of a suspected MI, oxygen is prioritized to ensure adequate oxygenation.
B. Aspirin: Aspirin is essential in the early treatment of MI to prevent further clot formation by inhibiting platelet aggregation, but oxygen would still come first if the client’s oxygenation is compromised.
C. Morphine: Morphine is used for pain relief and to reduce anxiety and oxygen demand on the heart. However, it is administered after ensuring oxygen supply.
D. Oxygen: Oxygen should be administered first in a suspected myocardial infarction to ensure the heart and tissues receive adequate oxygen, especially if the patient is hypoxic.
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