The nursing student is obtaining the patient's vital signs (VS). The patient has gone to the clinic seeking help because she is having chest pain. Which of the following vital signs are most important to obtain?
Temperature, pulse, respirations, BP
Temperature, pulse, respirations, BP, pain
BP. respirations, temperature, pulse
Temperature, pulse, respirations, blood pressure, O2 sat, pain
The Correct Answer is D
A. Temperature, pulse, respirations, BP. While these are standard vital signs, they do not include oxygen saturation or pain level, both of which are critical in a patient with chest pain.
B. Temperature, pulse, respirations, BP, pain. Pain is an essential assessment, especially for chest pain, but oxygen saturation should also be measured to assess for hypoxia, which can contribute to cardiac symptoms.
C. BP, respirations, temperature, pulse. This option omits both oxygen saturation and pain level, which are essential in evaluating cardiac and respiratory function in a patient presenting with chest pain.
D. Temperature, pulse, respirations, blood pressure, O2 sat, pain. This option includes all critical assessments for a patient with chest pain. Oxygen saturation helps assess respiratory and circulatory efficiency, and pain assessment is vital in determining the severity and possible cause of the chest pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. 4+. A 4+ pulse is bounding and strong, often seen in conditions like fever, anemia, or fluid overload. This does not match the description of a weak pulse.
B. 3+. A 3+ pulse is stronger than normal but not bounding. This is not considered weak.
C. 2+. A 2+ pulse is normal and easily palpable, which does not indicate the weakened pulse described in the patient.
D. 1+. A 1+ pulse is weak and thready, meaning it is difficult to palpate and easily disappears with slight pressure. This grading is appropriate for a hypotensive patient with poor perfusion.
Correct Answer is ["2"]
Explanation
Calculation:
Formula:
Tabletsperdose = Dose ordered/ Dose available
Given:
- Ordered dose = 100 mg
- Available dose = 50 mg per tablet
Tablets per dose = 100mg/ (50mg/tablet)
= 2 tablets
Thus, the nurse will administer 2 tablets per dose.
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