A client is to receive an intravenous dose of adenosine. What immediate response to this medication should the nurse expect?

Run of premature ventricular beats.

Short period of asystole.

Brief seizure episode.

Dramatic increase in blood pressure.

Answer and Explanation

The Correct Answer is B

A. Run of premature ventricular beats: While adenosine can occasionally provoke brief ventricular ectopy, this is not its primary or most expected effect. Premature ventricular contractions may occur transiently but are not the hallmark response to this medication.

B. Short period of asystole: Adenosine briefly blocks AV node conduction and can interrupt re-entry pathways, often resulting in a short period of asystole lasting a few seconds. This is an expected effect and reflects the drug’s mechanism in terminating supraventricular tachycardia by interrupting the reentrant pathway.

C. Brief seizure episode: Adenosine does not typically cause seizures. It acts primarily on cardiac tissue and has no significant pro-convulsant effects. A seizure would be an atypical and concerning adverse reaction rather than an expected response.

D. Dramatic increase in blood pressure: Adenosine causes transient vasodilation and may lead to a brief drop in blood pressure or flushing. A dramatic increase in blood pressure would not be expected and could suggest an alternate diagnosis or drug reaction.

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Correct Answer is A

Explanation

A. Narrowed pulse pressure: Aortic stenosis leads to obstruction of blood flow from the left ventricle to the aorta during systole, reducing systolic pressure while diastolic pressure remains unchanged or slightly elevated. This results in a narrowed pulse pressure, a classic finding in moderate to severe aortic stenosis.

B. Sinus tachycardia: While tachycardia can occur in response to decreased cardiac output or stress, it is not a defining feature of aortic stenosis. The hallmark findings relate more directly to fixed cardiac output and valve obstruction.

C. Apical diastolic murmur: Aortic stenosis produces a systolic ejection murmur, best heard at the right second intercostal space and radiating to the carotids. An apical diastolic murmur would suggest mitral stenosis or other diastolic valve pathology.

D. S3 heart sound: An S3 is more indicative of volume overload and heart failure rather than valvular stenosis. While advanced aortic stenosis can lead to heart failure, the S3 is not a primary or early manifestation of this condition.

A. Maintain the infusion because the client had a cardiac arrest. B. Continue to monitor the client's rhythm closely. C. Suggest that the client's medication be changed to norepinephrine. D. Ask the physician if the dose can be decreased.

Correct Answer is D

Explanation

A. Maintain the infusion because the client had a cardiac arrest: While epinephrine is essential during cardiac arrest, continuing a high-dose infusion post-resuscitation without reassessment may lead to complications like tachycardia, hypertension, and increased myocardial oxygen demand.

B. Continue to monitor the client's rhythm closely: Ongoing monitoring is important, but it is a passive intervention. The heart rate of 120 bpm may reflect excessive adrenergic stimulation from epinephrine, and further action is needed to prevent deterioration.

C. Suggest that the client's medication be changed to norepinephrine: Norepinephrine is another vasopressor that has less of a beta-1 adrenergic effect compared to epinephrine. It is primarily used for hypotension and septic shock, not as a direct substitute for epinephrine post-cardiac arrest. Changing to another vasopressor without indication is not the best initial step.

D. Ask the physician if the dose can be decreased: A heart rate of 120 bpm may indicate that the epinephrine dose is too high, causing sympathetic overstimulation. Prolonged or excessive tachycardia increases myocardial oxygen demand, which can be detrimental, especially in a post-arrest heart. Decreasing the dose can help prevent arrhythmias or myocardial ischemia, making this the most appropriate and proactive action.

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A client is to receive an intravenous dose of adenosine. What immediate response to this medication should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse understands that which of the following is a manifestation of aortic stenosis?

Correct Answer is A

Explanation

The nurse is caring for a client who has been successfully resuscitated following a cardiac arrest and is now on an IV infusion of epinephrine. The cardiac monitor shows a heart rate of 120 beats/minute. What should be the nurse's best action?

Correct Answer is D

Explanation

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