Progressive Care Nursing Certification (PCCN) Practice Exam

A patient with diabetes and hypertension presents with several concerning symptoms. What should the nurse do first?

1. Order a CT scan without contrast

2. Review meal selections with the dietitian

3. Inquire about recent sleep patterns

4. Obtain an order for an electrocardiogram

The correct answer is: Obtain an order for an electrocardiogram

Obtaining an order for an electrocardiogram (ECG) is the priority in this scenario due to the patient's underlying conditions of diabetes and hypertension, both of which significantly increase the risk for cardiovascular issues. In acute settings, patients with these health conditions can manifest symptoms indicative of myocardial ischemia or other cardiac problems. An ECG is a valuable and immediate diagnostic tool to assess the heart's electrical activity, identify potential arrhythmias, and reveal any signs of ischemia or other cardiac dysfunction. Prioritizing the ECG allows the nurse to quickly ascertain the patient's cardiac status, which is critical to guiding further interventions and treatments. Timely identification of any cardiac issues can lead to quicker management, potentially preventing serious complications. While reviewing meal selections with the dietitian, inquiring about sleep patterns, or ordering imaging studies may be important in the broader scope of the patient's management, these actions do not address acute symptoms or potential life-threatening conditions as directly or urgently as performing an ECG does.