After the shift change, which patient in the emergency department should the nurse prioritize for assessment?

A 39-year-old patient experiencing tenderness and swelling in the right calf following a flight.

A 58-year-old patient on anticoagulants for atrial fibrillation presenting with black stools.

A 67-year-old patient with a gangrenous foot ulcer and a weak pedal pulse.

A 50-year-old patient reporting sudden, severe upper back pain.

Answer and Explanation

The Correct Answer is B

Choice A rationale
A 39-year-old patient experiencing tenderness and swelling in the right calf following a flight may be experiencing deep vein thrombosis (DVT), a condition that can lead to serious complications such as pulmonary embolism if not treated. However, DVT is not immediately life-threatening in most cases.
Choice B rationale
A 58-year-old patient on anticoagulants for atrial fibrillation presenting with black stools is likely experiencing gastrointestinal bleeding, a common side effect of anticoagulant therapy. This can lead to severe blood loss, anemia, and hypovolemic shock, which can be life-threatening if not promptly addressed. Therefore, this patient should be prioritized for assessment.
Choice C rationale
A 67-year-old patient with a gangrenous foot ulcer and a weak pedal pulse likely has peripheral artery disease and an infection that could lead to sepsis if not treated. However, while this condition needs medical attention, it is not as immediately life-threatening as gastrointestinal bleeding.
Choice D rationale
A 50-year-old patient reporting sudden, severe upper back pain could be experiencing a number of conditions, ranging from musculoskeletal strain to aortic dissection. While an aortic dissection is a medical emergency, without additional symptoms such as chest pain, shortness of breath, or loss of consciousness, this patient is not the highest priority.

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Correct Answer is A

Explanation

Choice A rationale
Stable angina typically occurs with exertion and goes away with rest. The symptoms described, including substernal pain, discomfort in the left shoulder and jaw, which subside with rest, are characteristic of stable angina.
Choice B rationale
Prinzmetal angina, also known as variant angina, is a type of angina (chest pain) caused by spasms in the coronary arteries. These spasms occur most often in coronary arteries that have not become hardened due to plaque buildup. However, they can also occur in hardened arteries. The symptoms can be similar to those of stable angina, but the typical triggers for the episodes are different.
Choice C rationale
A myocardial infarction (MI), or heart attack, occurs when one of the coronary arteries becomes blocked, often by a blood clot, causing part of the heart muscle to be damaged or die. The symptoms are usually more severe than what is described and do not typically subside with rest.
Choice D rationale
Unstable angina is a condition in which the angina symptoms become more severe, occur more frequently, or occur at rest. This is a medical emergency as it can often lead to a heart attack.

A. Sinus tachycardia. B. Ventricular tachycardia. C. Ventricular fibrillation. D. Atrial flutter.

Correct Answer is B

Explanation

Choice A rationale
Sinus tachycardia is a regular, rapid heart rate caused by rapid firing of the sinoatrial node. It is characterized by a heart rate of greater than 100 beats per minute, and P waves are present before each QRS complex. This does not match the description given.
Choice B rationale
Ventricular tachycardia is a fast, regular beating of the ventricles that may last for only a few seconds or for much longer. In this condition, the ventricular rate is often between 120 and 200 beats per minute, and P waves are not associated with the QRS complexes. This matches the description given.
Choice C rationale
Ventricular fibrillation is a severe condition in which the heart beats with rapid, erratic electrical impulses. This causes the ventricles to quiver uselessly instead of pumping blood. The description does not match this condition.
Choice D rationale
Atrial flutter is a condition that shares similarities with atrial fibrillation, both involve an irregular heartbeat. However, atrial flutter is more organized and less chaotic than atrial fibrillation, which can make it more manageable. The description does not match this condition.

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After the shift change, which patient in the emergency department should the nurse prioritize for assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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