Which client electrocardiography (ECG) change from baseline will alert the nurse to possible development of hypercalcemia?

Shortened QT interval.

Inverted T waves.

Prominent U wave.

Absent P wave.

Answer and Explanation

The Correct Answer is A

Choice A reason: Hypercalcemia shortens the QT interval on ECG due to accelerated cardiac repolarization. This aligns with electrolyte-related cardiac monitoring, making it the correct change the nurse would recognize as indicating possible hypercalcemia in the client’s electrocardiography assessment.

Choice B reason: Inverted T waves suggest ischemia or hypokalemia, not hypercalcemia, which shortens the QT interval. This is incorrect, as it doesn’t align with the nurse’s expected ECG change for hypercalcemia compared to the characteristic shortened QT interval.

Choice C reason: Prominent U waves are associated with hypokalemia, not hypercalcemia, which affects the QT interval. Shortened QT is correct, making this incorrect, as it’s unrelated to the nurse’s monitoring for hypercalcemia’s ECG changes in the client.

Choice D reason: Absent P waves indicate atrial fibrillation, not hypercalcemia, which shortens the QT interval. This is incorrect, as it doesn’t reflect the nurse’s anticipated ECG change for hypercalcemia, unlike the characteristic shortened QT interval in the client’s monitoring.

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Correct Answer is C

Explanation

Choice A reason: Inverted T waves suggest ischemia but are less specific than troponin I, which confirms myocardial damage in ACS. This is incorrect, as it’s not the most significant finding within 3 hours compared to the nurse’s reliance on biomarkers for diagnosis.

Choice B reason: Peaked T waves indicate hyperkalemia, not ACS, which is diagnosed by troponin elevation. This is incorrect, as it’s unrelated to the nurse’s expected finding for acute coronary syndrome within the first 3 hours of symptom onset.

Choice C reason: Elevated troponin I is the most significant finding for ACS, indicating myocardial necrosis within 3 hours. This aligns with diagnostic criteria, making it the correct biomarker the nurse would prioritize to confirm acute coronary syndrome in the client.

Choice D reason: Troponin T is also specific for ACS but rises slightly later than troponin I, which is detectable sooner. This is incorrect, as troponin I is more significant within 3 hours for the nurse’s diagnosis of acute coronary syndrome.

A. Initiate seizure precautions. B. Tell the client to report vision changes. C. Elevate the head of the client’s bed. D. Start a peripheral IV.

Correct Answer is C

Explanation

Choice A reason: Seizure precautions are relevant but secondary to establishing IV access for antihypertensive administration in hypertensive crisis. Starting an IV enables immediate treatment, making this incorrect, as it delays the critical intervention needed to lower the client’s dangerously high blood pressure.

Choice B reason: Instructing to report vision changes monitors complications but doesn’t address the urgent need to lower blood pressure. IV access facilitates medication delivery, making this incorrect, as it postpones the primary action for managing the client’s hypertensive crisis effectively.

Choice C reason: Hypertensive crisis can cause severe headache, risk for stroke, pulmonary edema, and difficulty breathing. Elevating the HOB improves cerebral perfusion, reduces intracranial pressure, and eases breathing. This is an immediate, noninvasive, airway/circulation-supportive intervention.

Choice D reason: Needed for IV antihypertensive administration, but initial safety and circulation support (C) takes priority before establishing access.

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Which client electrocardiography (ECG) change from baseline will alert the nurse to possible development of hypercalcemia?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse in an emergency department is caring for a client who has a blood pressure of 254/139 mm Hg. The nurse recognizes that the client is in a hypertensive crisis. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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