A patient has pain due to acute pericarditis. Which action would the nurse take?.

Teach the patient to take deep, slow breaths to control the pain.

Place the patient in Fowler's position, leaning forward on the table.

Force fluids to 3000 mL/day to decrease the inflammation.

Provide a fresh ice bag every hour for the patient to place on the chest.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Teaching the patient to take deep, slow breaths might not be effective in controlling the pain due to acute pericarditis.

Choice B rationale:

Placing the patient in Fowler’s position, leaning forward on the table, can help relieve the pain associated with acute pericarditis.

Choice C rationale:

Forcing fluids to 3000 mL/day to decrease inflammation is not a recommended action for managing pain due to acute pericarditis.

Choice D rationale:

Providing a fresh ice bag every hour for the patient to place on the chest is not a recommended action for managing pain due to acute pericarditis.

So, the correct answer is B, after analyzing all choices.

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Correct Answer is D

Explanation

Choice A rationale:

The right upper-sternal border is not the best place to hear a murmur typical of mitral regurgitation.

Choice B rationale:

The left upper-sternal border is not the best place to hear a murmur typical of mitral regurgitation.

Choice C rationale:

The left lower-sternal border is not the best place to hear a murmur typical of mitral regurgitation.

Choice D rationale:

The apex of the heart is the best place to hear a murmur typical of mitral regurgitation. This is where the sound will be most audible.

So, the correct answer is Choice D, after analyzing all choices.

A. Dependent rubor. B. Digitalis toxicity. C. Carditis. D. Hypercyanotic spells. E. Hypokalemia. F. Fever. G. Hypertension.

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

Explanation

Choice A rationale:

Dependent rubor refers to redness of the skin that occurs when the leg is in a dependent (hanging down) position. It is often associated with peripheral artery disease. However, the child’s symptoms do not indicate this condition.

Choice B rationale:

Digitalis toxicity can occur as a result of high levels of the drug digoxin. Symptoms can include nausea, vomiting, weakness, and vision changes. Given that the child has been administered digoxin, there is a risk for this condition.

Choice C rationale:

Carditis is inflammation of the heart or its surroundings. It is usually caused by bacterial or viral infections. The child’s symptoms do not suggest an infection, making this choice less likely.

Choice D rationale:

Hypercyanotic spells, also known as “tet spells,” are associated with Tetralogy of Fallot, a specific congenital heart defect. The child has a history of congenital mitral stenosis, not Tetralogy of Fallot, making this choice less likely.

Choice E rationale:

Hypokalemia, or low potassium levels, can occur as a side effect of taking diuretics like furosemide. Given that the child has been administered furosemide, there is a risk for this condition.

Choice F rationale:

Fever is usually a response to infection or inflammation. The child’s symptoms do not suggest an infection or inflammation, making this choice less likely.

Choice G rationale:

Hypertension, or high blood pressure, is not indicated in the child’s symptoms or history. The child’s blood pressure readings are within normal range, making this choice less likely.

Choice H rationale:

A murmur is a sound that can be heard when listening to the heart with a stethoscope. It is often caused by turbulent blood flow through the heart. The child’s notes do not mention a murmur, making this choice less likely.

So, the correct answer is, the child is at risk for developing Digitalis toxicity and Hypokalemia. .

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A patient has pain due to acute pericarditis. Which action would the nurse take?.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with mitral regurgitation. Where would the nurse listen to best hear a murmur typical of mitral regurgitation?.

Correct Answer is D

Explanation

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

Explanation

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