The nurse is monitoring a 53-year-old client who is undergoing a cardiac exercise stress test after experiencing an episode of angina. Which client finding will require the test to be discontinued?

Heart rate of 134 bpm

Mild shortness of breath

Three premature ventricular contractions in a row

Blood pressure 152/88 mmHg

Answer and Explanation

The Correct Answer is C

A. Heart rate of 134 bpm. A heart rate of 134 bpm is expected during a cardiac stress test, as the goal is to increase the heart rate to a target range to evaluate cardiac function under stress.

B. Mild shortness of breath. Mild shortness of breath is a common response to exercise and is not an indication to stop the test unless it becomes severe or is accompanied by other concerning symptoms like chest pain or cyanosis.

C. Three premature ventricular contractions in a row indicate a potential serious arrhythmia (ventricular tachycardia), which is a contraindication for continuing the stress test. This finding could place the client at risk for life-threatening cardiac events, such as ventricular fibrillation.

D. Blood pressure 152/88 mmHg. This is a slightly elevated but normal physiological response to exercise and does not warrant discontinuation of the test unless the blood pressure rises to dangerously high levels (e.g., >200/110 mmHg).

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Correct Answer is B

Explanation

A. Aspirin 325 mg PO: Aspirin is important for preventing clot formation but should not be administered until a hemorrhagic stroke is ruled out.

B. Non-contrast computed tomography (CT) scan: This is the priority because it determines whether the stroke is ischemic or hemorrhagic, guiding further treatment.

C. Electrocardiogram (ECG): While assessing cardiac rhythm is important, it is not the immediate priority in the presence of stroke symptoms.

D. Simvastatin (Zocor) 80 mg PO: Statins are used for long-term management but are not urgent in this acute scenario.

A. Pelvic fracture B. Femoral neck fracture C. Tibia fracture D. Fibula fracture

Correct Answer is B

Explanation

A. Pelvic fracture: Pelvic fractures may cause significant pain and instability but do not typically result in a shortened, adducted, and externally rotated leg.

B. Femoral neck fracture: These findings (shortened, adducted, externally rotated leg) are classic for a femoral neck fracture due to muscle contraction and displacement of the bone.

C. Tibia fracture: Tibia fractures typically present with swelling and deformity, not shortening or rotation of the leg.

D. Fibula fracture: A fibula fracture alone rarely causes leg shortening or rotation as it is a non-weight-bearing bone.

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The nurse is monitoring a 53-year-old client who is undergoing a cardiac exercise stress test after experiencing an episode of angina. Which client finding will require the test to be discontinued?

Nursing Test Bank

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