After receiving shift change report, which of the following patients should the nurse see first?

Patient with history of mitral valve prolapse

Patient post op endovascular graft procedure for a 5.7cm abdominal aortic aneurysm with a urine output of 35mL/hr

Patient with infecting endocarditis having new onset flank pain and hematuria

Patient awaiting discharge after pacemaker surgery 2 days ago

Answer and Explanation

The Correct Answer is C

A.   While mitral valve prolapse requires ongoing monitoring, it is not a critical or immediately life- threatening condition.
B.   A urine output of 35 mL/hr is slightly low but not critically concerning. This patient can be monitored closely and interventions can be implemented if necessary, but they do not require immediate attention.
C.   New-onset flank pain and hematuria in a patient with infective endocarditis suggest a potential complication, such as renal infarction or abscess. These conditions can be life-threatening and require prompt intervention.
D.   While this patient requires ongoing monitoring, they are not in a critical condition and can be seen after addressing the patient with infective endocarditis.

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Correct Answer is A

Explanation

A. An imaging test that uses sound waves to visualize the heart and its structures. It can help to identify abnormalities in the heart muscle, such as thickening, enlargement, or decreased contractility. Echocardiograms are a valuable tool for diagnosing cardiomyopathy and assessing the severity of the condition.
B. Cardiac enzyme studies are used to diagnose myocardial infarction (heart attack). While they can be helpful in evaluating cardiac function, they are not the most specific test for diagnosing cardiomyopathy.
C. Cardiac catheterization is an invasive procedure that is used to diagnose and treat certain heart conditions. While it can provide valuable information about the heart's function, it is not the most appropriate initial test for diagnosing cardiomyopathy.
D. This procedure is used to treat certain types of arrhythmias. It is not a diagnostic test and would not be appropriate for diagnosing cardiomyopathy.

A. Administer digoxin B. Continue to monitor the client. C. Defibrillate the client. D. Prepare for transcutaneous pacing

Correct Answer is D

Explanation

A. Digoxin is a medication used primarily to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It works by increasing the force of heart contractions and slowing the heart rate. However, digoxin is not typically used to treat bradycardia and may actually exacerbate the condition by further slowing the heart rate.
B. While monitoring is an essential part of patient care, it is not sufficient alone in this situation. The client’s heart rate is very low (45 beats per minute) and their blood pressure is low (82/60 mm Hg), which suggests they are symptomatic and potentially unstable.
C. Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. It is not used for sinus bradycardia, which is a slow heart rate rather than a rapid, disorganized rhythm requiring electrical shock.

D. Transcutaneous pacing involves applying external pacing pads to the skin to stimulate the heart and increase the heart rate. This is a suitable intervention for symptomatic bradycardia, especially when accompanied by low blood pressure and dizziness.

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After receiving shift change report, which of the following patients should the nurse see first?

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Naxlex Comprehensive Predictor Exams

A patient is admitted with suspected cardiomyopathy. What diagnostic test would be most helpful with the identification of this disorder?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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