After receiving the shift change report about four patients in the cardiac care unit, which patient should the nurse prioritize for assessment?

A 59-year-old patient with unstable angina who has just returned from a percutaneous coronary intervention (PCI).

A 56-year-old patient with variant angina due to receive nifedipine (Procardia).

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

A 39-year-old patient with pericarditis complaining of sharp, stabbing chest pain.

Answer and Explanation

The Correct Answer is A

Choice A rationale
A 59-year-old patient with unstable angina who has just returned from a percutaneous coronary intervention (PCI) should be prioritized for assessment. PCI is a procedure to open blocked or narrowed coronary arteries and can lead to complications such as re-occlusion of the artery or bleeding from the catheter insertion site. Furthermore, unstable angina is a condition that can progress to myocardial infarction if not managed effectively.
Choice B rationale
A 56-year-old patient with variant angina due to receive nifedipine (Procardia) requires monitoring, but is not the highest priority. Variant angina is a form of angina that occurs at rest, often with severe pain, but it is usually well-controlled with medications like nifedipine.
Choice C rationale
A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and is anxious about discharge planned for today is a lower priority for assessment. While it’s important to address the patient’s anxiety and provide education about post-discharge care, this patient is not in immediate danger.
Choice D rationale
A 39-year-old patient with pericarditis complaining of sharp, stabbing chest pain requires assessment, but is not the highest priority. Pericarditis is inflammation of the pericardium, the sac-like covering of the heart, and while it can cause severe pain, it is not typically life- threatening.

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Correct Answer is D

Explanation

Choice A rationale
Increasing glomerular filtration would result in increased urine output, not decreased venous return. This action is not directly related to the therapeutic action of nitroglycerin.
Choice B rationale
While enhancing the contractility of the myocardium would increase oxygen delivery, this is not the primary action of nitroglycerin. Nitroglycerin primarily works by dilating the blood vessels, which reduces the amount of work the heart has to do and increases the blood supply to the heart muscle.
Choice C rationale
Nitroglycerin does not produce an immediate analgesic effect. While it can relieve chest pain, it does so by increasing blood flow to the heart, not by acting as an analgesic.
Choice D rationale
Nitroglycerin increases the coronary blood supply and decreases the afterload314. By dilating the blood vessels, nitroglycerin reduces the amount of work the heart has to do and increases the blood supply to the heart muscle. This is the primary therapeutic action of nitroglycerin in alleviating chest pain.

A. Bradycardia, palpitations, confusion, truncal rash. B. Severe respiratory distress, jugular venous distention, chest pain. C. Low blood pressure and tachycardia. D. Reduced cardiac output, increased systemic vascular resistance, moist cough.

Correct Answer is C

Explanation

Choice A rationale
Bradycardia, palpitations, confusion, and truncal rash are not typically associated with septic shock. Septic shock is a severe infection that occurs when bacteria enter the bloodstream. It can cause organs to fail and can lead to death.
Choice B rationale
Severe respiratory distress, jugular venous distention, and chest pain are more commonly associated with conditions like heart failure or pulmonary embolism, not septic shock.
Choice C rationale
Low blood pressure and tachycardia are common symptoms of septic shock. This happens because the body’s response to the infection causes blood vessels to dilate, which can lower blood pressure. The heart rate often increases (tachycardia) in an attempt to maintain blood flow to the organs.
Choice D rationale
Reduced cardiac output, increased systemic vascular resistance, and a moist cough are not typical symptoms of septic shock. These symptoms are more commonly associated with conditions like heart failure.

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After receiving the shift change report about four patients in the cardiac care unit, which patient should the nurse prioritize for assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is administering nitroglycerin intravenously to alleviate chest pain. What is the therapeutic action of this medication?

Correct Answer is D

Explanation

A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit?

Correct Answer is C

Explanation

What positive outcome should a nurse anticipate in a patient taking Vasotec, an Angiotensin-Converting Enzyme (ACE) inhibitor?

A patient is being admitted to the emergency department with intermittent chest pain. They provide a list of daily medications. Which medication from the list has the most immediate implications for the patient’s care?

When caring for a client who has developed cardiac tamponade, what assessments should the nurse expect to find?

A 49-year-old male presents with chest pain. An EKG reveals ST elevation, and he is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial for this patient?

Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as what type of hypertension?

A patient with heart failure has recently started taking Digoxin (Lanoxin), Furosemide (Lasix), and Captopril. Which finding by the home health nurse is a priority to communicate to the healthcare provider?

A 52-year-old male is diagnosed with chronic venous insufficiency, presenting with pooling of blood in the veins of the lower extremities and edema. Which of the following is an expected assessment finding of this disorder?

Given the electrocardiogram tracing below for a client who is unresponsive and without a pulse, what should be the nurse’s priority action?