After receiving a change-of-shift report, which patient admitted to the emergency department should the nurse assess first?
A 39-year-old patient who has right calf tenderness and swelling after a plane ride
A 58-year-old patient taking anticoagulants for atrial fibrillation who has black stools
A 67-year-old patient who has a gangrenous foot ulcer with a weak pedal pulse
A 50-year-old patient who is reporting sudden sharp and severe upper back pain .
The Correct Answer is D
Choice A rationale
While calf tenderness and swelling after a plane ride could potentially indicate a deep vein thrombosis, this condition is not immediately life-threatening in most cases. The patient would need evaluation and treatment, but other patients might have more urgent needs14.
Choice B rationale
A patient taking anticoagulants for atrial fibrillation who has black stools could potentially have gastrointestinal bleeding, which would need evaluation. However, this condition might not be immediately life-threatening, and other patients might have more urgent needs14.
Choice C rationale
A patient with a gangrenous foot ulcer and a weak pedal pulse would need evaluation and treatment. However, this condition might not be immediately life-threatening, and other patients might have more urgent needs14.
Choice D rationale
A patient reporting sudden sharp and severe upper back pain could potentially have an aortic dissection, which is a life-threatening condition that requires immediate evaluation and treatment. Therefore, this patient should be assessed first14.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: Adenosine Adenosine is a naturally occurring substance that relaxes and dilates blood vessels. It also affects the electrical activity of the heart. Adenosine is used to help restore normal heartbeats in people with certain heart rhythm disorders. However, it is not typically used for atrial fibrillation.
Choice B rationale: Diltiazem Diltiazem belongs to a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. Diltiazem also increases the supply of blood and oxygen to the heart. It is used in adults alone or in combination with other medications to treat hypertension (high blood pressure) or symptoms of angina (chest pain). Diltiazem injection is used in adults to treat certain heart rhythm disorders such as atrial fibrillation.
Choice C rationale: Atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. However, it is not typically used for atrial fibrillation.
Choice D rationale: Captopril Captopril is used in adults alone or in combination with other medications to treat high blood pressure (hypertension) and congestive heart failure.
Captopril is also used to improve survival and reduce the risk of heart failure after a heart attack in patients with a heart condition called left ventricular hypertrophy (enlargement of the walls of the left side of the heart)4. However, it is not typically used for atrial fibrillation.
Correct Answer is C
Explanation
Choice A rationale
While assessing the gag reflex is important in certain situations, such as after surgery involving anesthesia, it is not typically a crucial assessment following Percutaneous Transluminal Angioplasty (PTA) of the lower extremity.
Choice B rationale
Checking for dye allergies is important before a procedure that uses contrast dye. However, it is not a crucial post-procedure assessment.
Choice C rationale
Monitoring of pedal pulses is crucial following PTA of the lower extremity. This is because the procedure involves the arteries in the legs, and monitoring pedal pulses can help assess blood flow to the area and detect potential complications such as occlusion or clot formation.
Choice D rationale
While the Ankle-Brachial Index can be used to diagnose Peripheral Arterial Disease (PAD), it is not typically a crucial assessment immediately following PTA3.
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