ANCC CV-BC Prep Online

New-onset slurred speech with unilateral weakness in the immediate postoperative period is concerning for an acute stroke or other neurologic emergency. The priority is to escalate immediately by activating the facility’s stroke/rapid response process and promptly notifying the responsible surgical/cardiac provider team so time-sensitive evaluation and treatment can begin without delay. The choice mentioning administering aspirin right away is inappropriate because antiplatelet therapy may be contraindicated after recent surgery and should not be given before urgent evaluation and orders. The choice describing a complete head-to-toe examination before calling delays definitive evaluation and time-critical interventions. The choice that says to apply oxygen at 100% regardless of saturation is not the first priority unless hypoxemia is present; escalation for suspected stroke is still required.

A potassium level of 2.8 mEq/L with symptoms and new dysrhythmias indicates clinically significant hypokalemia with risk for worsening arrhythmias. The priority is to begin potassium replacement promptly according to institutional protocol and to maintain continuous cardiac monitoring while correcting the electrolyte abnormality. Dietary potassium teaching and sodium restriction may be appropriate after stabilization, but they do not correct symptomatic hypokalemia quickly enough. Holding the diuretic may prevent further losses, but it does not address the immediate danger from the current low potassium level and rhythm changes.

In symptomatic HFrEF, guideline-directed medical therapy includes an evidence-based beta-blocker (such as carvedilol, metoprolol succinate, or bisoprolol). These agents have robust trial evidence showing improvement in clinical outcomes, including reduced heart-failure hospitalizations and improved survival, when titrated as tolerated. Self-monitoring strategies like weighing can help with early recognition of fluid retention, but they are supportive measures and are not, by themselves, a substitute for therapies proven to reduce hospitalization risk. Similarly, sodium restriction and appropriate physical activity are commonly advised as part of overall management, but neither “very strict sodium restriction as the primary strategy” nor “only seated activities” represents the key evidence-based intervention to reduce hospitalization in stable HFrEF.