The nurse has received a change-of-shift report on the following clients. Which client should the nurse see first?

A patient with second-degree atrioventricular (AV) block, type 1. rate 60, who is dizzy when ambulating

A patient who is in a sinus rhythm, rate 98 and regular, recovering from an elective cardioversion 2 hours ago

A patient with atrial fibrillation, rate 88 and irregular, who has a dose of warfarin (Coumadin) due

A patient whose implantable cardioverter-defibrillator (ICD) fired twice today and has a dose of amiodarone (Cordarone) due.

Answer and Explanation

The Correct Answer is D

A. A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating. While dizziness may be a concern, second-degree AV block type 1 (Wenckebach) typically resolves without immediate intervention.

B. A patient who is in a sinus rhythm, rate 98 and regular, recovering from an elective cardioversion 2 hours ago. This patient is stable, and recovery from cardioversion typically involves monitoring, but the patient does not require immediate intervention.

C. A patient with atrial fibrillation, rate 88 and irregular, who has a dose of warfarin (Coumadin) due. The patient is stable, and the dose of warfarin can be administered after assessing the patient’s overall condition, making it a lower priority.

D. A patient whose implantable cardioverter-defibrillator (ICD) fired twice today and has a dose of amiodarone (Cordarone) due: The patient whose ICD fired twice is at high risk for life-threatening arrhythmias, and this situation requires immediate evaluation and intervention. The nurse should assess the patient first, and the dose of amiodarone may be administered to manage any underlying arrhythmias.

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Correct Answer is D

Explanation

A. Occurs during stress: This describes stable angina, which is precipitated by predictable stress or exertion.

B. Occurs without any EKG changes: Unstable angina often presents with reversible ischemic EKG changes, such as ST depression or T wave inversion.

C. Occurs with reversible EKG changes: While this is true for unstable angina, it is not the primary differentiator compared to other types of angina.

D. Occurs at rest: Correct. Unstable angina is characterized by chest pain that occurs at rest or with minimal exertion, differentiating it from stable angina.

A. "It is an amino acid which reflects damage to the endothelial lining of arteries. B. "It is a substance composed of free fatty acids reflective of atherosclerosis C. "It is a reliable indicator of the presence of heart failure." D. “It is a protein produced by the liver in response to systemic inflammation."

Correct Answer is C

Explanation

A. "It is an amino acid which reflects damage to the endothelial lining of arteries." BNP is not related to endothelial damage.

B. "It is a substance composed of free fatty acids reflective of atherosclerosis." BNP is not composed of free fatty acids, and it does not reflect atherosclerosis.

C. "It is a reliable indicator of the presence of heart failure." BNP is a hormone released by the heart in response to increased pressure and volume. Elevated levels of BNP are commonly used as a diagnostic marker for heart failure, especially during exacerbations or decompensation.

D. "It is a protein produced by the liver in response to systemic inflammation." BNP is produced by the heart, not the liver.

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The nurse has received a change-of-shift report on the following clients. Which client should the nurse see first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client with unstable angina. Which finding would the nurse expect the client to report that differentiates this from other types of anginas?

Correct Answer is D

Explanation

The nurse is teaching a group of staff nurses about brain (B-type) natriuretic peptide (BNP). Which statement by the group would indicate that they understand the instruction?

Correct Answer is C

Explanation

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