A nurse is performing an electrocardiogram (ECG) on a client who is experiencing chest pain. Which of the following statements should the nurse make?

The test will be complete in 30 to 60 minutes.

You may feel a slight tingling while the test is being done.

The radioactivity from the dye lasts only a few hours.

I will need to apply electrodes to your chest and extremities.

Answer and Explanation

The Correct Answer is D

Choice A reason : The statement that the test will be complete in 30 to 60 minutes is incorrect. An ECG is a quick, non-invasive procedure that typically takes only a few minutes to perform.

Choice B reason : The statement about feeling a slight tingling is not accurate for an ECG. This test does not cause any sensations, as it simply records the electrical activity of the heart.

Choice C reason : The mention of radioactivity from dye is not applicable to an ECG. This test does not involve the use of any dyes or radioactive substances. Dyes are typically used in imaging tests like CT scans or MRIs, not ECGs.

Choice D reason : This is the correct statement. For an ECG, electrodes are placed on the patient's chest and extremities to record the electrical activity of the heart. This allows the healthcare provider to assess the heart's rhythm, identify any irregularities, and diagnose conditions.

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Correct Answer is A

Explanation

Choice A reason: Pain assessment is a critical priority for postoperative patients. After aortic valve replacement surgery, patients may experience discomfort or pain related to the incision site, chest tube placement, or other surgical interventions. Pain assessment allows the nurse to evaluate the effectiveness of pain management strategies, adjust medications as needed, and ensure the patient's comfort and well-being. Pain can also impact vital signs and overall recovery, so addressing it promptly is essential.

Choice B reason: Monitoring blood pressure is important, but it is not the highest priority immediately after surgery. Blood pressure assessment is part of routine postoperative care, but it does not directly address the patient's immediate comfort or potential complications. However, if the patient's blood pressure becomes significantly abnormal, it would require immediate attention.

Choice C reason: Checking bowel sounds is relevant for assessing gastrointestinal function, but it is not the top priority immediately postoperatively. Bowel sounds may be diminished initially due to anesthesia, surgical manipulation, or bowel rest. However, assessing pain and other vital signs takes precedence over bowel sounds in the immediate recovery period.

Choice D reason: Assessing the catheter insertion site is essential, especially if the patient has an indwelling urinary catheter. However, it is not the highest priority immediately after aortic valve replacement. Pain assessment and monitoring for complications related to surgery (such as bleeding, infection, or cardiac issues) take precedence. The catheter site can be assessed during routine nursing care.

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate B. Obtain a 12-lead ECG C. Administer potassium gluconate 40 mEq orally D. Restrict fluid intake

Correct Answer is B

Explanation

Choice A reason : An erythrocyte sedimentation rate (ESR) test is not directly related to high serum potassium levels and would not be the immediate action in response to hyperkalemia.

Choice B reason : Obtaining a 12-lead ECG is a critical step when hyperkalemia is suspected because high potassium levels can cause life-threatening cardiac arrhythmias. An ECG can quickly reveal characteristic changes associated with hyperkalemia, allowing for prompt treatment.

Choice C reason : Administering potassium gluconate would be contraindicated in a patient with hyperkalemia, as it would further increase the serum potassium levels, potentially leading to severe complications.

Choice D reason : Restricting fluid intake is not a standard treatment for hyperkalemia. The management of hyperkalemia may include medications or procedures that promote the excretion of potassium or move potassium from the blood into the cells.

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A nurse is performing an electrocardiogram (ECG) on a client who is experiencing chest pain. Which of the following statements should the nurse make?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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