The nurse is caring for clients on a busy cardiac unit. Following morning assessment, the nurse would notify the physician with which of the following symptoms?
Dyspnea when ambulating from the bathroom
A noted irregular pulse rate prior to Lanoxin (digoxin) administration
Pulsus paradoxus on vital sign assessment
Cyanosis with a pulse oximetry level of 92%
The Correct Answer is C
A. Dyspnea when ambulating from the bathroom: Mild exertional dyspnea is common in cardiac clients and may not require immediate provider notification unless it worsens or becomes unrelieved with rest.
B. A noted irregular pulse rate prior to Lanoxin (digoxin) administration: An irregular pulse may warrant holding the medication and further assessment, but it is not always an emergency unless associated with hemodynamic instability or bradycardia.
C. Pulsus paradoxus on vital sign assessment: Pulsus paradoxus, a significant drop in systolic blood pressure during inspiration, may indicate cardiac tamponade or severe pericardial effusion. It is a critical finding that requires immediate medical attention.
D. Cyanosis with a pulse oximetry level of 92%: While cyanosis is concerning, a SpO₂ of 92% may be acceptable for some cardiac or pulmonary patients. Further monitoring is needed, but it may not require urgent notification unless oxygen levels drop further.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. An angiotensin receptor blocker (ARB): ARBs, such as losartan or valsartan, block the angiotensin II receptor but are pharmacologically distinct from ACE inhibitors. Captopril is not classified in this drug group.
B. A calcium channel blocker: Calcium channel blockers, such as amlodipine, reduce blood pressure by relaxing vascular smooth muscle. Captopril does not function through calcium channel modulation and is unrelated to this class.
C. An angiotensin converting enzyme inhibitor (ACE) inhibitor: Captopril is an ACE inhibitor that lowers blood pressure and reduces afterload by inhibiting the conversion of angiotensin I to angiotensin II. It is commonly prescribed for heart failure management to improve cardiac output and prevent fluid overload.
D. A thiazide diuretic: Thiazide diuretics like hydrochlorothiazide promote sodium and water excretion. They help manage hypertension but work differently from captopril, which targets the renin-angiotensin-aldosterone system.
Correct Answer is C
Explanation
A. "Removing the tumor is a primary treatment for colon cancer.": Surgical removal is primary in early-stage cancer, but not when metastasis is widespread. At this point, the focus shifts from curative to palliative care.
B. "Once the tumor is removed, cell pathology can be determined.": Pathology is typically confirmed through prior biopsies. Surgery in advanced cases is not usually done for diagnostic purposes.
C. "Tumor removal will promote comfort.": In metastatic colon cancer, surgery is often palliative, aiming to relieve symptoms such as pain, obstruction, or bleeding. The goal is to enhance quality of life.
D. "This surgery will prevent further tumor growth.": With metastasis to the liver and bone, tumor growth is likely ongoing elsewhere. Surgery may reduce local tumor burden but does not prevent systemic progression.
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