The nurse is doing a physical assessment and electrocardiogram on an elderly client. Which finding during the nurse’s assessment of the cardiac system is of most concern and warrants prompt further investigation?

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Nursing Health Assessment Questions Questions

Question 1 of 5

The nurse is doing a physical assessment and electrocardiogram on an elderly client. Which finding during the nurse’s assessment of the cardiac system is of most concern and warrants prompt further investigation?

Correct Answer: D

Rationale: An irregularly irregular heart rate (D) suggests atrial fibrillation, a serious condition requiring urgent investigation in the elderly due to stroke risk. S4 (A) and PR increase (B) are common aging findings, and orthostatic hypotension (C) is less cardiac-specific.

Question 2 of 5

The nurse is caring for a client with a fractured femur in skeletal traction. Which assessment finding indicates a complication?

Correct Answer: A

Rationale: Warmth and redness at the pin site (A) suggest infection, a traction complication. Pain relief (B), alignment (C), and no spasms (D) are expected outcomes.

Question 3 of 5

Which signs and symptoms are indicators of inadequate clotting? Select one that apply..

Correct Answer: A

Rationale: Purpura (A) indicate poor clotting. Itching (B) and poor skin turgor (E) are unrelated.

Question 4 of 5

How will the nurse document the client's cognitive status when he or she experiences recent confusion with a rapid onset?

Correct Answer: A

Rationale: Delirium (A) is characterized by rapid-onset confusion. Amnesia (B) is memory loss. Dementia (C) is chronic and progressive. Intermittent confusion (D) is not a formal diagnosis.

Question 5 of 5

Which is the common IV additive that can only be added to IV solutions but not pushed directly intravenously?

Correct Answer: C

Rationale: Potassium chloride must be diluted in IV solutions and never pushed directly due to risk of cardiac arrhythmias. Metronidazole (A) Vitamin C (B) and sodium chloride (D) can be administered differently based on context.

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