After receiving a change-of-shift report on four patients, which patient would the nurse assess first?.

Patient with dilated cardiomyopathy who has bilateral crackles at the lung bases.

Patient with acute aortic regurgitation whose blood pressure is 86/54 mm Hg.

Patient with infective endocarditis who has a murmur and splinter hemorrhages.

Patient with rheumatic fever who has sharp chest pain with a deep breath.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While bilateral crackles at the lung bases indicate fluid accumulation, a common symptom of dilated cardiomyopathy, it’s not as immediately life-threatening as some other conditions.

Choice B rationale:

Acute aortic regurgitation can lead to a rapid and severe drop in blood pressure, which is a medical emergency. Therefore, this patient should be assessed first.

Choice C rationale:

While a murmur and splinter hemorrhages are symptoms of infective endocarditis, they are not as immediately life-threatening as acute aortic regurgitation.

Choice D rationale:

Sharp chest pain with a deep breath could be a symptom of rheumatic fever, but it’s not as immediately life-threatening as acute aortic regurgitation.

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

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Correct Answer is B

Explanation

Choice A rationale:

Checking the pulse rate before taking nitroglycerin is not necessary.

Choice B rationale:

Sitting down before taking nitroglycerin can prevent dizziness and fainting, which are potential side effects of nitroglycerin.

Choice C rationale:

There is no need to remove the nitroglycerin patch before taking sublingual nitroglycerin.

Choice D rationale:

The nitroglycerin patch should not be used to treat acute chest pain.

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

A. The pain has lasted longer than 30 minutes. B. The pain increases with deep breathing. C. The pain is relieved after the patient takes nitroglycerin. D. The pain is reproducible when the patient raises the arms.

Correct Answer is A

Explanation

Choice A rationale:

Chest pain that lasts for 20 minutes or more is characteristic of an acute myocardial infarction (AMI)123.

Choice B rationale:

Changes in pain that occur with deep breathing are more typical of musculoskeletal pain or pericarditis.

Choice C rationale:

Stable angina is usually relieved when the patient takes nitroglycerin.

Choice D rationale:

Pain that is reproducible when the patient raises the arms is more typical of musculoskeletal pain.

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

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After receiving a change-of-shift report on four patients, which patient would the nurse assess first?.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which patient statement indicates that the teaching has been effective?.

Correct Answer is B

Explanation

The nurse is admitting a patient who has chest pain. Which assessment data suggest that the pain may be from an acute myocardial infarction?.

Correct Answer is A

Explanation

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

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After receiving a change-of-shift report about the following four patients on the cardiac care unit, which patient would the nurse assess first?.

Which patient statement would help the nurse confirm the previous diagnosis of chronic stable angina?.

Which patient statement indicates that the nurse's teaching about sublingual nitroglycerin (Nitrostat) has been effective?.

A patient is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction (STEMI). Which question would the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?.