Page 1764 - Saunders Comprehensive Review For NCLEX-RN

output. These assessment findings should direct you to an option that includes
active collaboration with the PHCP.
Level of Cognitive Ability: Synthesizing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Complex Care—Emergency Situations/Management
Health Problem: Adult Health: Cardiovascular: Vascular Disorders
Priority Concepts: Clinical Judgment; Perfusion
Reference: Lewis et al. (2014), pp. 841-843.

623. Answer: 4

Rationale: Variant angina, or Prinzmetal’s angina, is prolonged and severe and
occurs at the same time each day, most often at rest. The pain is a result of coronary
artery spasm. The treatment of choice is usually a calcium channel blocker, which
relaxes and dilates the vascular smooth muscle, thus relieving the coronary artery
spasm in variant angina. Adverse effects can include peripheral edema, hypotension,
bradycardia, and heart failure. Grapefruit juice interacts with calcium channel
blockers and should be avoided. If bradycardia occurs, the client should contact the
primary health care provider or cardiologist. Clients should also be taught to change
positions slowly to prevent orthostatic hypotension. Physical exertion does not cause
this type of angina; therefore, the client should be able to continue morning walks
with her or his spouse.
Test-Taking Strategy: Note the strategic words, need for further teaching, and focus
on the data in the question. These words indicate a negative event query and the
need to select the incorrect client statement. Recall that walking is a low-impact
exercise and is usually recommended for clients with heart problems.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health: Cardiovascular
Health Problem: Adult Health: Cardiovascular: Coronary artery disease
Priority Concepts: Client Education; Safety
Reference: Ignatavicius, Workman (2016), pp. 759, 763.

624. Answer: 3

Rationale: Ventricular fibrillation is characterized by irregular chaotic undulations
of varying amplitudes. Ventricular fibrillation has no measurable rate and no visible
P waves or QRS complexes and results from electrical chaos in the ventricles.
Test-Taking Strategy: Focus on the subject, the characteristics of ventricular
fibrillation. Note the words, no definable QRS complexes. The lack of visible QRS
complexes eliminates atrial fibrillation and ventricular tachycardia. Recalling that
asystole is lack of any electrical activity of the heart will direct you to the correct
option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity

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