A patient recovering from a myocardial infarction (MI) develops cheat pain on day 3 that increases when taking a deep breath, lying flat, and is relieved by leaning forward. Which additional assessment data should the nurse collect next?
Auscultate for a pericardial friction rub
Inspect the skin for petechia
Palpate the radial pulses bilaterally
Assess for abdominal pain
The Correct Answer is A
A. Auscultate for a pericardial friction rub: These symptoms are classic for pericarditis, a complication of MI. A pericardial friction rub is a key diagnostic finding.
B. Inspect the skin for petechiae: Petechiae are associated with conditions like infective endocarditis or thrombocytopenia, not pericarditis.
C. Palpate the radial pulses bilaterally: Assessing radial pulses is essential for circulation but does not directly relate to pericarditis symptoms.
D. Assess for abdominal pain: Abdominal pain is not typical of pericarditis and would not be the priority assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Pacemaker: Pacemakers are used for bradyarrhythmias or heart block, not typically for atrial flutter.
B. Cardiac catheterization: This is used for diagnostic or interventional procedures, not for rhythm correction.
C. Pulmonary artery pressure monitoring: This is a monitoring tool for critically ill clients with heart failure or pulmonary hypertension, not a treatment for atrial flutter.
D. Cardioversion: Cardioversion is often used for atrial flutter when drug therapy fails. It delivers synchronized electrical energy to restore normal sinus rhythm.
Correct Answer is D
Explanation
A. Restlessness: This may occur in the pre-active phase of dying but is not specific to the actively dying phase.
B. Decreased appetite: A reduced appetite is common earlier in the dying process, not specific to the actively dying phase.
C. Skin pallor: Skin changes, such as pallor, occur earlier; mottling is more indicative of the actively dying phase.
D. Anuria: Anuria (absence of urine output) is a hallmark sign of multisystem failure and the actively dying phase.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
