The night nurse in the cardiac ICU has just received a report on several patients. Which of the following clients should the nurse prioritize for rounds?

A patient with a new-onset of confusion and restlessness.

A patient who reports dizziness after receiving captopril (Capoten).

A patient who requires oxygen via nasal cannula with saturations of 97%.

A patient who has received digoxin and has a blood pressure (BP) of 100/56.

Answer and Explanation

The Correct Answer is A

Choice A reason: A patient with a new-onset of confusion and restlessness is a priority because these symptoms could indicate a serious condition such as hypoxia, electrolyte imbalance, or a neurological event like a stroke. These changes in mental status need to be evaluated immediately to prevent further complications.

Choice B reason: Dizziness after receiving captopril (Capoten) can be a side effect of the medication due to its blood pressure-lowering effects. While it should be monitored, it is not as urgent as the new-onset confusion and restlessness seen in another patient.

Choice C reason: A patient requiring oxygen via nasal cannula with saturations of 97% is stable as the oxygen saturation is within normal limits. This patient does not need to be prioritized over others with more acute symptoms.

Choice D reason: A patient who has received digoxin and has a blood pressure of 100/56 should be monitored, especially for signs of digoxin toxicity. However, this situation is not as critical as the new-onset confusion and restlessness in another patient.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Symmetrical joint pain that is relieved with rest is more characteristic of osteoarthritis, not rheumatoid arthritis. RA typically involves persistent, symmetrical joint pain and inflammation.

Choice B reason: Unilateral pain in the weight-bearing joints is not characteristic of RA. Rheumatoid arthritis generally affects joints symmetrically on both sides of the body.

Choice C reason: Symmetrical joint pain is a hallmark of rheumatoid arthritis. RA causes inflammation and pain in multiple joints, typically affecting the same joints on both sides of the body.

Choice D reason: Hypoglycemia is not related to rheumatoid arthritis. RA primarily involves joint inflammation and systemic symptoms like fatigue and fever but does not directly impact blood sugar levels.

A. Limit the client's fluid intake in the evening B. Put the side rails up and tell the client to call the nurse before voiding C. Obtain a bedside commode for the client's use D. Leave a nightlight on in the client's room

Correct Answer is C

Explanation

Choice A reason: Limiting fluid intake in the evening may reduce the need to urinate at night but does not address the client's fear of falling. It is more important to provide a safer alternative for nighttime voiding.

Choice B reason: Putting the side rails up and instructing the client to call the nurse before voiding may help, but it does not provide the most immediate and practical solution. A bedside commode offers a safer and more accessible option.

Choice C reason: Obtaining a bedside commode for the client's use directly addresses the client's concern about falling. It allows the client to void safely without having to walk to the bathroom at night, reducing the risk of falls.

Choice D reason: Leaving a nightlight on in the room can help improve visibility but does not completely eliminate the risk of falling. A bedside commode is a more effective solution.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The night nurse in the cardiac ICU has just received a report on several patients. Which of the following clients should the nurse prioritize for rounds?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is caring for an older adult client who states, "I am afraid that I may fall while walking to the bathroom during the night." Which of the following actions should the nurse take?

Correct Answer is C

Explanation

The nurse is caring for a client who is in the oliguric phase of an acute kidney injury. Which of the following clinical manifestations would be consistent with the condition?

A client diagnosed with angina pectoris appears to be very anxious and states, "So I had a heart attack, right?" Which response should the nurse make to the client?

A client on the unit is diagnosed with rapid atrial fibrillation. Which medication is the healthcare provider likely to prescribe to correct this rhythm?

A client diagnosed with glomerulonephritis is at risk for developing acute kidney injury. Which of the clinical manifestations should the nurse monitor for?

A client received atropine intraoperatively for symptomatic sinus bradycardia during a cardiac catheterization. In the immediate postoperative period, the nurse monitors the client for which effects of the medication?

The nurse is performing a neurological assessment on the older adult. An expected finding is that:

The nurse is caring for a client who was prescribed digoxin. Which manifestations correlate with a digoxin level of 3.0 (Range: 0.8-2.0)? (Select all that apply)

The nurse is caring for a client post-thyroidectomy that is showing clinical manifestations of hypocalcemia. Which of the following would the nurse expect to find during the assessment?