A client has a temporary demand pacemaker. During your AM assessment you note that the client's heart rate is 40 bpm, and the client is hypotensive. There are no pacer spikes evident on the rhythm strip. You suspect
failure to sense.
failure to pace.
failure to synchronize.
failure to capture.
The Correct Answer is B
A. Failure to sense occurs when the pacemaker does not recognize intrinsic cardiac activity, leading to inappropriate pacing, but pacer spikes are usually present.
B. Failure to pace is indicated when the pacemaker does not deliver electrical impulses, evidenced by the absence of pacer spikes on the rhythm strip. This explains the low heart rate and hypotension.
C. Failure to synchronize occurs with synchronized cardioversion, not in demand pacemakers.
D. Failure to capture occurs when pacer spikes are present but do not result in ventricular depolarization; in this case, pacer spikes are absent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Orthostatic hypotension is not a common or severe adverse effect of simvastatin or gemfibrozil.
B. Generalized joint aches and pain may occur but are usually mild and not immediately dangerous.
C. Severe skin flushing is more associated with niacin therapy, not simvastatin or gemfibrozil.
D. Dark, tea-colored urine indicates potential rhabdomyolysis, a serious adverse effect of combining simvastatin and gemfibrozil, and requires immediate communication to the healthcare provider for intervention.
Correct Answer is A
Explanation
A. Fever increases metabolic demand and oxygen consumption, which can reduce SvO₂ by increasing tissue extraction of oxygen.
B. Serum amylase is related to pancreatic function and is not directly associated with SvO₂ changes.
C. Body surface area does not acutely affect SvO₂ levels in this context.
D. Decreased urinary output indicates possible renal hypoperfusion but is a secondary effect and does not directly explain decreased SvO₂.
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