After receiving change-of-shift report about the following four clients, which client should the nurse assess first?

56-year-old client with chronic stable angina who is due to receive a dose of nifedipine.

59-year-old with unstable angina who has just returned to the unit after having a heart catheterization with balloon angioplasty.

65-year-old who had a myocardial infarction (MI) 4days ago and is anxious about the planned discharge.

Client who is post coronary artery bypass, with potassium 4.2 mEq/L.

Answer and Explanation

The Correct Answer is B

A. A stable client with chronic angina is not in immediate danger, and the scheduled dose of nifedipine is not an urgent priority.

B. The client with unstable angina who has just undergone a heart catheterization with balloon angioplasty requires immediate assessment for complications such as bleeding, clot formation, or re-occlusion of the artery.

C. The 65-year-old post-MI client is stable, and while their anxiety is important to address, it is not an immediate concern compared to other clients.

D. The client post-coronary artery bypass with a potassium level of 4.2 mEq/L is stable and does not require urgent intervention.

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Correct Answer is B

Explanation

A. Blurred vision is not a typical symptom of left-sided heart failure.

B. Difficulty breathing while performing activities, such as climbing stairs, is a classic symptom of left-sided heart failure due to pulmonary congestion.

C. Increased water intake is not directly indicative of left-sided heart failure.

D. Nocturia can occur in heart failure, but it is less specific than dyspnea on exertion.

A. Test the equipment by delivering a smaller shock at 50 J. B. Administer 2 mg of intravenous epinephrine. C. Make sure that the defibrillator is set to the synchronous mode. D. Ensure that everyone is clear of contact with the client and the bed.

Correct Answer is D

Explanation

A. Testing the equipment with a smaller shock is unnecessary when preparing to defibrillate in an emergency.

B. Epinephrine is used in cases of cardiac arrest with no pulse, particularly in asystole or pulseless electrical activity (PEA), not immediately before defibrillation in ventricular fibrillation.

C. Synchronous mode is used for cardioversion, not for defibrillation. Defibrillation should be delivered in unsynchronized mode.

D. Before delivering a shock, it is essential to ensure that everyone, including the nurse, is clear of the client and any conductive surfaces like the bed. This prevents injury from the electrical shock.

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After receiving change-of-shift report about the following four clients, which client should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

Correct Answer is B

Explanation

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?

Correct Answer is D

Explanation

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