Med-Surg Final Exam 2013

A client is admitted for treatment of hypoparathyroidism. Based on the client's diagnosis, the nurse would anticipate an order for:

a. Potassium
b. Magnesium
c. Calcium
d. Iron
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A client with heart failure is receiving digoxin intravenously. The nurse should determine the effectiveness of the drug by assessing which of the following?

a. Dilated coronary arteries
b. Increased myocardial contractility
c. Decreased cardiac arrhythmias
d. Decreased electrical conductivity in the heart
A client has returned to the medical-surgical unit after a cardiac catheterization. Which is the MOST important initial postprocedure nursing assessment for this client?

a. Monitor the laboratory values
b. Observe neurologic function every 15 minutes
c. Observe the puncture site for swelling and bleeding
d. Monitor skin warmth and turgor
The nurse assesses the respiratory status of a client who is experiencing an exacerbation of chronic obstructive pulmonary disease (COPD) secondary to an upper respiratory tract infection. Which of the following findings would be expected? a. Normal breath sounds b. Prolonged inspiration c. Normal chest movement d. Coarse crackles and rhonchiDA client admitted to the hospital with chest pain and history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which of the following medications would need to be withheld for 48 hours before and after the procedure? a. Regular insulin b. Glipizide (Glucotrol) c. Repaglinide (Prandin) d. Metformin (Glucophage)DA client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink tinged sputum. Which of the following would the nurse anticipate when auscultating the client's breath sounds? a. Stridor b. Crackles c. Scattered rhonchi d. Diminished breath soundsBA nurse is caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosisAA nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to the one with no P waves, no definable QRS complexes, and coarse wavy lines of varying amplitude. How would the nurse correctly interpret this rhythm? a. Asystole b. Atrial fibrillation c. Ventricular fibrillation d. Ventricular tachycardiaCA client is admitted to an emergency department with chest pain that is being ruled out for myocardial infarction. Vital signs are as follows: at 11am → P - 92, RR - 24, BP - 140/88; at 11:15am → P - 96, RR - 26, BP - 128/82; at 11:30am → P - 104, RR - 28, BP - 104/68; at 11:45am → P - 118, RR - 32, BP - 88/58. The nurse should alert the physician because these changes are most consistent with which of the following complications? a. Cardiogenic shock b. Cardiac tamponade c. Pulmonary embolism d. Dissecting thoracic aortic aneurysmAA nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 100 bpm. The nurse determines that the client is experiencing which of the following dysrhythmias? a. Sinus tachycardia b. Ventricular fibrillation c. Ventricular tachycardia d. Premature ventricular contractionsCA client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? a. It can develop into ventricular fibrillation at any time b. It is almost impossible to convert to a normal rhythm c. It is uncomfortable for the client, giving a sense of impending doom d. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemiaAA client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following? a. Sensation of palpitations b. Causative factors, such as caffeine c. Precipitating factors, such as infection d. Blood pressure and oxygen saturationDA nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead, there are fibrillatory waves before each QRS complex. How should the nurse correctly interpret the client's heart rhythm? Atrial fibrillation Sinus tachycardia Ventricular fibrillation Ventricular tachycardiaAA nurse is evaluating a client's response to cardioversion. Which of the following would be of highest priority to the nurse? Blood pressure Status of airway Oxygen flow rate Level of consciousness (LOC)BA client's electrocardiogram strip shows atrial and ventricular rates of 110 bpm. The PR interval is 0.14 second, the QRS complex measure 0.08 second, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm? Sinus dysrhythmia Sinus tachycardia Sinus bradycardia Normal sinus rhythmBA client with angina complains that the anginal pain is prolonged and severe and occurs at the same time each day, most often at rest in the absence of precipitating factors. How would the nurse best describe this type of anginal pain? Stable angina Variant angina Unstable angina Nonanginal painBA client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is complaining of anorexia. A physician prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin? 0.5 to 2 ng/mL 1.2 to 2.8 ng/mL 3 to 5 ng/mL 3.5 to 5.5 ng/mL0.5 to 2 ng/mLA nurse provides discharge instructions to a post-operative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching? a. "I will take my pills every day at the same time" b. "I will avoid alcohol consumption" c. "I have already called my family to pick up a Medic-Alert bracelet" d. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated"DA nurse is caring for a client receiving a heparin IV infusion. The nurse anticipates that which laboratory study will be prescribed to monitor the therapeutic effect of heparin? Hematocrit Hemoglobin Prothrombin Time Activated partial thromboplastin timeDA client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions? "It is not necessary to avoid the use of alcohol" "The medication should be taken with meals to decrease flushing" "Clay-colored stools are a common side effect and should not be of concern" "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing"DA 66 year old client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include: atenolol (Ternormin), digoxin (Lanoxin), and chlorothiazide (Diuril). A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis? a. Dyspnea, edema, and palpitations b. Chest pain, hypotension, and paresthesia c. Double vision, loss of appetite, and nausea d. Constipation, dry mouth, and sleep disorderCA client with atrial fibrillation is receiving a continuous heparin infusion at 1,000 units/hr. The nurse would determine that the client is receiving a therapeutic effect based on which of the following results? a. Prothrombin time of 12.5 seconds b. Activated partial thromboplastin time of 60 seconds c. Activated partial thromboplastin time of 28 seconds d. Activated partial thromboplastin time longer than 120 secondsBA middle adult male client is seen in the emergency department with reports of nausea, vomiting, dizziness, and weakness. History reveals that he has had just completed a 10-mile run when the onset of symptoms occurred. Physical assessment reveals dry oral mucous membranes, temperature 38.5 C (101.3 F), pulse 92 beats/min and thready, respirations 20/min, skin cool and tenting present, and blood pressure 102/64 mmHg. His urine is concentrated with a high specific gravity. Which of the following are consistent with the presence of fluid volume deficit? (select all that apply) a. Decreased skin turgor b. Concentrated urine c. Tachycardia d. Low-grade fever e. Hypertensiona. Decreased skin turgor b. Concentrated urine c. Tachycardia d. Low-grade feverA client being discharged to home after angioplasty via the right femoral groin as the catheter insertion site has received discharge instructions from the nurse. Client learning is evident if which of the following statements is made? a. Coolness or discoloration of the right foot is expected b. I should expect a large area of bruising at the right groin c. Temperature as high as 101F is nit unusual a few days after the procedure d. Mild discomfort in the right groin may occur, and Tylenol should relieve the painDA client who has been newly diagnosed with angina pectoris asks the nurse how to prevent future angina attacks. The nurse plans to incorporate which instruction in a teaching session? a. Eat fewer, larger meals for more efficient digestion b. Dress appropriately in very cold or very hot weather c. Adjust medication doses freely until your symptoms do not recur d. Plan all activities for early in the morning, when you are the most restedBWho are most common to develop an abdominal aortic aneurysm? Select all that apply: a. African American b. Caucasians c. Men d. Women e. ElderlyCaucasians Women ElderlyWhich of the following classes of drugs is most widely used in the treatment of cardiomyopathy? a. Antihypertensive b. Beta-adrenergic blockers c. Calcium channel blockers d. NitratesBWhich of the following types of cardiomyopathy does not affect cardiac output? a. Dilated b. Hypertrophic c. Restrictive d. ObliterativeBA nurse is caring for an 83-year-old woman in a long term care facility who has a history of heart failure and peripheral arterial disease. The patient is unable to stand or ambulate. The nurse knows this places the client at significant risk for: a. Aoritis b. Deep vein thrombosis c. Thoracic aortic aneurysm d. Raynaud's diseaseBDyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions? Pericarditis Hypertension Obliterative cardiomyopathy Restrictive cardiomyopathyDSeptal involvement occurs in which type of cardiomyopathy? Congestive Dilated Hypertrophic RestrictiveCWhich of the following present fluid volume excess? (select all that apply) a. Dyspnea b. Edema c. Bradycardia d. Hypertension e. Weaknessa. Dyspnea b. Edema d. Hypertension e. Weakness *NOT bradycardiaWhich of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client? Bruit Crackles Dullness Friction rubsAA client is being treated with procainamide (Procanbid) for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first? a. Administer prescribed nitroglycerin tablets b. Measure the heart rate on the rhythm strip c. Obtain a 12-lead electrocardiogram immediately d. Auscultate the client's apical pulse and obtain a blood pressureDWhen assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated? a. Right upper quadrant b. Directly over the umbilicus c. Middle lower abdomen to the left of the midline d. Midline lower abdomen to the right of the midlineCWhich of the following should the nurse look for when assessing for fluid volume deficit? a. Moist skin b. Distended neck veins c. Increased urinary output d. HypotensionDA client receiving 0.9% sodium chloride should be monitored for signs of? a. Fluid overload b. Fluid deficitAnurse is caring for a client who has a potassium level of 5.4 mEq/L. The nurse should assess the client for? a. ECG changes b. Constipation c. Polyuria d. HypotensionAWhich of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client? HPN Aneurysm rupture Cardiac arrythmias Diminished pedal pulsesBWhich of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm? Abdominal pain Absent pedal pulses Angina Lower back painDFor which of the following electrolyte imbalance should the nurse monitor a client who has a nasogastric tube with suctioning? a. Hyperkalemia b. Hypernatremia c. Hypokalemia and hyponatremia d. HypomagnesemiaCA client has developed atrial fibrillation, with a ventricular rate of 150 bpm. The nurse should assess the client for which associated signs or symptoms? Flat neck veins Nausea and vomiting Hypotension and dizziness Hypertension and headacheCWhich of the following conditions might result in hyperkalemia? a. Diabetic ketoacidosis b. Heart failure c. Diabetes insipidus d. ThyroidectomyAWhat is the first intervention for a client experiencing myocardial infarction? a. Administer morphine b. Administer oxygen c. Administer sublingual nitroglycerin d. Obtain an electrocardiogramBWhich of the following diagnostic tools is most commonly used to determine the location of myocardial damage? a. Cardiac catheterization b. Cardiac enzymes c. Echocardiogram d. ElectrocardiogramDA client is in the first trimester of pregnancy. She has experienced approximately 1 week of severe nausea with frequent vomiting. Which of the following conditions should the nurse expect to find if an arterial blood gas is analyzed? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosisBA nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the physician and prepares to implement which priority interventions? Select all that apply: Administering oxygen Inserting a foley catheter Administering furosemide (Lasix) Administering morphine sulfate intravenously Transporting the client to the coronary care unit Placing the client in a low Fowler's side lying positionAdministering oxygen Inserting a foley catheter Administering furosemide (Lasix) Administering morphine sulfate intravenouslyWhat is the primary reason for administering morphine to a client with myocardial infarction? To sedate the client To decrease the client's pain To decrease the client's anxiety To decrease oxygen demand on the client's heartDThe nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 second. The overall heart rate is 64 bpm. Which of the following would be a correct interpretation based on these characteristics? Sinus bradycardia Sick sinus syndrome Normal sinus rhythm First-degree heart blockCWhen do coronary arteries primarily receive blood flow? During inspiration During diastole During expiration During systoleBWhich of the following arteries primarily feeds the anterior wall of the heart? Circumflex artery Internal mammary artery Left anterior descending artery Right coronary arteryCWhich of the following clients are at risk for development of dysrhythmias? (Select all that apply) a. Metabolic alkalosis b. A client who has a serum potassium level of 4.3 mEd/L c. A client who has an SaO2 of 96% d. A client who has COPD e. A client who is 3 hr post MIa. Metabolic alkalosis d. A client who has COPD e. A client who is 3 hr post MIA client seeks treatment in an ambulatory care center for symptoms of Raynaud's disease. The nurse instructs the client to: a. decrease cigarette smoking by one half b. alternate exposures to both heat and cold c. continue activity during vasospasm for quicker relief of symptoms d. wear protective items, such as gloves and warm socks, as necessaryDA client has now received a permanent pacemaker. Which of the following statements indicate a need for further teaching? "I will notify the airport screeners about my pacemaker." "I will call if I notice hiccups or muscle twitching." "I will have to disconnect my garage door opener." "I will take my pulse every morning when I awake."CA pt is diagnosed with severe hyponatremia. The nurse realizes this pt will mostly likely need which of the following precautions implemented? seizure infection neutropenic high-risk fallAA pt is diagnosed with hypokalemia. After reviewing the pt's current medications, which of the following might have contributed to the pt's health problem? Corticosteroid Thiazide diuretic Narcotic Muscle relaxerBA nurse is caring for a client who is in the immediate postoperative period following a CABG surgery. The client is 4 hr postextubation. He has refused to cough because he is tired and it hurts too much. He is only able to inspire 200 mL with the incentive spirometer. Which of the following is an appropriate nursing intervention? a. Let the client rest for now and return in 1 hr to try again. b. Administer morphine sulfate 4 mg IV bolus, and return in 10 to 15 min to try again. c. Document the 200 mL as an appropriate volume d. Tell the client that he will have to learn to breathe through the pain if he does not want to get pneumonia.BA client with myocardial infarction is developing cardiogenic shock. Because of the risk of myocardial ischemia, for which of the following should the nurse carefully assess the client? Bradycardia Ventricular dysrhythmias Rising diastolic blood pressure Falling central venous pressureBNurse would be most concerned about which lab values obtained from a client receiving furosemide (Lasix) therapy? a. BUN 20 b. K 3.6 c. Creatinine 1.1 d. K 3.2DNurse inserts a nasogastric tube, and it immediately drains 1000 mL of fluid. Which of the following electrolyte level is of greatest concern at this time? a. Na b. K c. Cl d. CO2BThe nurse should observe for a Trousseau sign in the client with which of the following electrolyte abnormalities? a. Hypokalemia b. Hyponatremia c. Hypochloremia d. HypocalcemiaDWhich of the following findings will help a nurse distinguish angina from an MI? Angina can be relieved by rest and nitroglycerin An MI will be relieved by nitroglycerin An MI will have cardiac enzyme levels within the expected reference rage Angina can occur for longer than 30 minutesAA nurse is caring for a client following an angioplasty that was inserted through the femoral artery. While turning the client, the nurse discovers blood underneath the client's lower back. The nurse should suspect Retroperitotneal bleeding Cardiac tamponade Bleeding from the incisional site Heart failureCA client who had cardiac surgery 24 hours ago has a urine output averaging 20 mL/hr for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 ml. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL and the serum creatinine level is 2.2 mg/dL. Based on these findings, the nurse would anticipate that the client is at risk for which for the following: Hypovolemia Acute renal failure Glomerulonephritis Urinary tract infectionBIt is especially important for the nurse to assess for which of the following in a patient who has just undergone a total thyroidectomy? weight gain depressed reflexes positive Chvostek's sign confusion and personality changesChe typical fluid replacement for the patient with an ICF fluid volume deficit is isotonic. hypotonic. hypertonic. a plasma expander.BThe following four clients are all at risk for fluid volume excess. Which of the clients should the nurse see first? a. 88-year-old client with a fractured femur scheduled for surgery b. 20-year-old client with a 5-year history of type 1 diabetes mellitus c. 65-year-old client recently diagnosed with congestive heart failure d. 50-year-old client with second-degree burns on the ankles and feetCA client who has a diagnosis of an MI reports that dyspnea began 2 weeks ago. Which of the following cardiac enzymes should the nurse assess to determine if the infarction occurred 14 days ago? CK-MB Troponin I Troponin T MyoglobinCA client asks the nurse why her provider prescribed 1 aspirin per day. Which of the following responses should the nurse give? "Aspirin reduces the formation of blood clots that could cause a heart attack." "Aspirin decreases any pain due to myocardial ischemia." "Aspirin dissolves any clots that are forming in your coronary arteries." "Aspirin relieves any headaches that are caused by other medications."AA client is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). For which electrolyte abnormality will you be sure to monitor? Hypokalemia Hyperkalemia Hyponatremia HypernatremiaCA nurse is assigned to care for a group of clients. On review of the client's medical records, the nurse determines that which client is at risk for fluid volume excess? The client taking diuretics The client with renal failure The client with an ileostomy The client who requires gastrointestinal suctioningBYou are reviewing a client's morning laboratory results. Which of these results is of most concern? Serum potassium 5.2 mEq/L Serum sodium 134 mEq/L Serum calcium 10.6 mg/dL Serum magnesium 0.8 mEq/LDA nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level? The client with Cushing's syndrome The client who is taking diuretics The client with hyeraldosteronism The client who is taking corticosteroidsBThe nursing assistant reports to you that a client seems very anxious and that vital signs included a respiratory rate of 38 per minute. Which acid-base imbalance should you suspect? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosisBA nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible for the artifact? Frequent movement of the client Tightly secured cable connections Leads applied over hairy areas Leads applied to the limbsBA nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: Premature ventricular contractions Ventricular tachycardia Ventricular fibrillation Sinus tachycardiaBMATCHING Sodium Potassium Calcium Magnesium 9-10.5 136-145 1.3-2.1 3.5-5Sodium - 136 to 145 Potassium - 3.5 to 5 Calcium - 9 to 10.5 Magnesium - 1.3 to 2.1A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following? Immediately defibrillate Prepare for pacemaker insertion Administer amiodarone (Cordarone) intravenously Administer epinephrine (Adrenaline) intravenouslyCMATCHING P wave QRS T wave U wave Ventricular depolarization Repolarization of the purkinje fibers Ventricular repolarization Atrial depolarizationP wave - atrial depolarization QRS - ventricular depolarization T wave - ventricular repolarization U wave - repolarization of the purkinje fibersA nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do which of the following, if prescribed, during an episode of ventricular tachycardia? Breathe deeply, regularly, and easily. Inhale deeply and cough forcefully every 1 to 3 seconds. Lie down flat in bed Remove any metal jewelryBMATCHING PR interval QRS complex QT interval 0.04 - 0.12 0.12 - 0.2 0.32 - 0.4PR interval - 0.12 to 0.2 seconds QRS complex - 0.04 to 0.12 seconds QT interval - 0.32 to 0.4 secondsA client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following items? Blood pressure and peripheral perfusion Sensation of palpitations Causative factors such as caffeine Precipitating factors such as infectionAA nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as: Sinus tachycardia Atrial fibrillation Ventricular tachycardia Ventricular fibrillationBA client with rapid rate atrial fibrillation asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the: Vagus nerve to slow the heart rate Vagus nerve to increase the heart rate; overdriving the rhythm. Diaphragmic nerve to slow the heart rate Diaphragmic nerve to overdrive the rhythmAA nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be: Ventricular tachycardia Ventricular fibrillation Atrial fibrillation AsystoleBWhen ventricular fibrillation occurs in a CCU, the first person reaching the client should: Administer oxygen Defibrillate the client Initiate CPR Administer sodium bicarbonate intravenouslyBWhat criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply. The RR intervals are relatively consistent One P wave precedes each QRS complex Four to eight complexes occur in a 6 second strip The ST segment is higher than the PR interval The QRS complex ranges from 0.12 to 0.20 secondThe RR intervals are relatively consistent One P wave precedes each QRS complexA 68-year-old woman is scheduled to undergo mitral valve replacement for severe mitral stenosis and mitral regurgitation. Although the diagnosis was made during childhood, she did not have any symptoms until 4 years ago. Recently, she noticed increased symptoms, despite daily doses of digoxin and furosemide. During the initial interview with the nice lady, the nurse would most likely learn that the client's childhood health history included: Chicken pox poliomyelitis Rheumatic fever meningitisCWhen auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by: The presence of occasional coupled beats Long pauses in an otherwise regular rhythm A continuous and totally unpredictable irregularity Slow but strong and regular beatsCWhich of the following signs and symptoms would most likely be found in a client with mitral regurgitation? Exertional dyspnea Confusion Elevated creatine phosphokinase concentration Chest painAThe nurse expects that a client with mitral stenosis would demonstrate symptoms associated with congestion in the: a. Aorta b. Right atrium c. Superior vena cava d. Pulmonary circulationDWhen interpreting an ECG, the nurse would keep in mind which of the following about the P wave? Select all that apply. a. Reflects electrical impulse beginning at the SA node b. Indicated electrical impulse beginning at the AV node c. Reflects atrial muscle depolarization d. Identifies ventricular muscle depolarizationC. Reflects electrical impulse beginning at the SA node D. Identifies atrial muscle depolarizationA client with no history of cardiovascular disease comes into the ambulatory clinic with flu-like symptoms. The client suddenly complains of chest pain. Which of the following questions would best help a nurse to discriminate pain caused by a non-cardiac problem? a. "Have you ever had this pain before?" b. "Can you describe the pain to me?" c. "Does the pain get worse when you breathe in?" d. "Can you rate the pain on a scale of 1-10, with 10 being the worst?"C