A client who is on the progressive care unit develops supraventricular tachycardia (SVT). The clients vital signs: T: 98, HR: 160, BP: 119/71, RR: 19, Sp02 94% on RA. The client presents with no dyspnea, shortness of breath or chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

Perform immediate defibrillation.

Perform immediate cardioversion.

Administer Adenosine 6 mg IVP.

Administer Adenosine 12 mg IVP.

Answer and Explanation

The Correct Answer is C

A. Defibrillation is used for life-threatening arrhythmias like ventricular fibrillation or pulseless ventricular tachycardia, not for SVT.

B. Cardioversion is appropriate for certain arrhythmias, but in this case, SVT with a stable pulse can be treated initially with medication like adenosine.

C. Adenosine is the first-line treatment for SVT. The typical starting dose is 6 mg IVP, which can be repeated if necessary. Adenosine works by temporarily blocking the electrical conduction through the AV node, allowing the heart to reset to a normal rhythm.

D. A 12 mg dose of Adenosine is used if the 6 mg dose is ineffective, but the 6 mg dose is typically administered first.

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Correct Answer is D

Explanation

A. Although monitoring hemodynamic parameters is important, this option does not address the immediate issue of low preload, as indicated by the low CVP and PAWP, suggesting hypovolemia.

B. Furosemide is a diuretic and would further decrease intravascular volume, which is inappropriate given the signs of hypovolemia.

C. Decreasing IV fluids would exacerbate the low preload and worsen the client's condition by reducing intravascular volume even further.

D. Administering 0.9% Normal Saline @ 150 mL/hr is the most appropriate intervention. The low CVP and PAWP indicate hypovolemia, and increasing fluid administration will help to increase the preload, thereby improving the client's hemodynamic status.

A. Client with serum phosphorus level of 4.5 mg/dL. B. Client with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes. C. Client with serum potassium level of 5.0 mEq/L who is complaining of abdominal cramping. D. Client with serum sodium level of 145 mEq/L who has a dry mouth and is asking for a glass of water.

Correct Answer is B

Explanation

A. Client with serum phosphorus level of 4.5 mg/dL: This is within the normal range for phosphorus (2.5-4.5 mg/dL), and the client does not require immediate assessment.

B. Client with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes: This is the correct answer. A magnesium level of 1.1 mEq/L is below the normal range (1.5-2.5 mEq/L), and symptoms like tremors and hyperactive reflexes indicate hypomagnesemia, which can lead to serious complications such as arrhythmias.

C. Client with serum potassium level of 5.0 mEq/L who is complaining of abdominal cramping: A potassium level of 5.0 mEq/L is within the normal range (3.5-5.0 mEq/L), so this client does not need immediate intervention.

D. Client with serum sodium level of 145 mEq/L who has a dry mouth and is asking for a glass of water: A sodium level of 145 mEq/L is at the upper end of normal (135-145 mEq/L), and the symptoms are likely due to dehydration or a normal response.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

After receiving change-of-shift report, which client should the nurse assess first?

Correct Answer is B

Explanation

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