A nurse us collecting data from a client who has right sided heart faiulure. Which of the following should the nurse expect?

Crackles

Productive cough

Hepatomegaly

Dizziness

Answer and Explanation

The Correct Answer is C

A. Crackles: Crackles in the lungs are a sign of left-sided heart failure, as fluid backs up into the pulmonary system.

B. Productive cough: A productive cough is also more commonly associated with left-sided heart failure, as it can result from fluid accumulation in the lungs.

C. Hepatomegaly: Hepatomegaly is a sign of right-sided heart failure, as blood backs up into the systemic circulation, leading to congestion in the liver.

D. Dizziness: Dizziness may occur in left-sided heart failure due to decreased cardiac output, but it is not a typical finding in right-sided heart failure.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","E"]

Explanation

A. Use alcohol pad to wipe the skin before placing the electrodes: Cleaning the skin with alcohol before applying the electrodes helps remove oils and dirt, ensuring better contact and more accurate readings.

B. "No movement during the test, you should try to lay still." The client should remain still during the ECG to avoid muscle movements or artifacts that can interfere with the ECG tracing.

C. Inspect electrodes while preparing for test: Inspecting electrodes ensures that they are functioning correctly and are not damaged, which can affect the accuracy of the ECG.

D. Administer an analgesic prior to the procedure: An analgesic is not necessary for an ECG as the procedure is non-invasive and painless.

E. Instruct the client to breathe normally: Instructing the client to breathe normally helps avoid unnecessary movement of the chest, which could distort the ECG tracing.

F. Keep the client NPO after midnight: There is no need to keep the client NPO for an ECG, as it is not a procedure requiring sedation or fasting.

A. Check the client's blood pressure. B. Offer the client a light snack. C. Measure the client's apical pulse. D. Weigh the client. E. Correct answer: C

Correct Answer is C

Explanation

A. Check the client's blood pressure: Digoxin primarily affects the heart rate and rhythm, not the blood pressure. Therefore, while BP monitoring is important, it's not required before giving digoxin.

B. Offer the client a light snack: Digoxin can be taken with or without food, so this is not a necessary action before administration.

C. Measure the client's apical pulse : It is important to check the apical pulse for one full minute before administering digoxin. If the heart rate is below 60 bpm, the nurse should withhold the medication and notify the provider.

D. Weigh the client: Weighing the client may be necessary for monitoring fluid balance in heart failure, but it is not a specific action required before administering digoxin.

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A nurse us collecting data from a client who has right sided heart faiulure. Which of the following should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is planning to perform an electrocardiogram (ECG) for a client who has a history of coronary heart disease. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

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Correct Answer is C

Explanation

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