The nurse is providing discharge instructions to a 76-year-old male client with chronic atrial fibrillation who has a CHA2DS2-VASC score of 2. Which medication would the nurse identify as most likely to be prescribed for the client?
Propranolol
Procainamide
Aspirin
Warfarin
The Correct Answer is D
A. Propranolol: This is a beta-blocker, which may be used to control heart rate, but it does not address the risk of thromboembolism in atrial fibrillation.
B. Procainamide: This is an antiarrhythmic used for rhythm control, but it does not address stroke prevention in atrial fibrillation.
C. Aspirin: Although aspirin is sometimes used for stroke prevention, it is generally less effective than anticoagulation therapy in clients with higher CHA2DS2-VASC scores.
D. Warfarin: A CHA2DS2-VASC score of 2 indicates a moderate risk for stroke, and warfarin (or another anticoagulant) is indicated to reduce the risk of thromboembolic events.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Auscultate for a pericardial friction rub: These symptoms are classic for pericarditis, a complication of MI. A pericardial friction rub is a key diagnostic finding.
B. Inspect the skin for petechiae: Petechiae are associated with conditions like infective endocarditis or thrombocytopenia, not pericarditis.
C. Palpate the radial pulses bilaterally: Assessing radial pulses is essential for circulation but does not directly relate to pericarditis symptoms.
D. Assess for abdominal pain: Abdominal pain is not typical of pericarditis and would not be the priority assessment.
Correct Answer is C
Explanation
A. The client is able to sit erect without assistance: This suggests a lower level injury, likely below C-2, as higher injuries often result in paralysis of respiratory muscles.
B. The client is able to move fingers slightly: This would be indicative of a higher level injury, but C-1 to C-2 injuries typically result in complete paralysis below the neck.
C. The client is displaying shallow respirations: Injuries at the C-1 or C-2 level can affect the diaphragm and the ability to breathe deeply, leading to shallow respirations.
D. The client is able to speak in full sentences: A C-1 to C-2 injury would likely affect the ability to speak, as it could impair the phrenic nerve and respiratory muscles needed for adequate breathing and speech.
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