A client with paroxysmal supraventricular tachycardia asks the nurse why the health care provider (HCP) is going to perform carotid sinus massage. The nurse educates the client about the treatment. Which statement by the client indicates that the teaching has been effective?

"The diaphragmatic nerve overdrives the rapid rhythm."

"Vagal stimulation decreases peripheral vascular resistance."

"The vagus nerve increases the heart rate, overdriving the rhythm."

"The vagus nerve slows the heart rate"

Answer and Explanation

The Correct Answer is D

A. "The diaphragmatic nerve overdrives the rapid rhythm:" The phrenic (diaphragmatic) nerve controls the diaphragm for breathing and plays no role in cardiac rhythm regulation. It is unrelated to the autonomic control of heart rate or supraventricular tachycardia (SVT) management.

B. "Vagal stimulation decreases peripheral vascular resistance:" Vagal stimulation primarily affects the heart by decreasing the rate and conduction through the AV node. Its effect on vascular resistance is minimal, making this explanation inaccurate in the context of SVT treatment.

C. "The vagus nerve increases the heart rate, overdriving the rhythm:" The vagus nerve has a parasympathetic effect, slowing down the heart rate, not increasing it. Overdrive pacing is a different concept and not related to vagal maneuvers like carotid massage.

D. "The vagus nerve slows the heart rate": The carotid sinuses in the neck contain baroreceptors that are sensitive to pressure. Massaging these sinuses stimulates the vagus nerve to release acetylcholine, which in turn slows conduction through the AV node and may terminate episodes of SVT. This response demonstrates an accurate understanding of the purpose of the procedure.

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Correct Answer is C

Explanation

A. BP 105/70 manually & flat neck veins: This blood pressure is within a low-normal range, and flat neck veins suggest no evidence of right-sided heart failure or cardiac tamponade. Though the patient needs evaluation, these findings are not emergent.

B. Equal breath sounds with a respiratory rate of 28: A mildly elevated respiratory rate can indicate distress, but equal breath sounds suggest the absence of pneumothorax or hemothorax. While the patient is symptomatic, this finding alone doesn't demand the most urgent intervention.

C. Distended neck veins & muffled heart sounds: These are classic signs of cardiac tamponade, a life-threatening emergency that can occur due to pacemaker lead perforation. This condition results in fluid accumulation in the pericardial sac, impairing cardiac output and requiring immediate intervention such as pericardiocentesis.

D. Heart rate 105 & respiratory rate of 28: These are signs of physiological compensation and indicate stress or early decompensation. However, without signs like neck vein distention or muffled heart sounds, they are less critical than the findings in option C.

A. Narrowed pulse pressure B. Sinus tachycardia C. Apical diastolic murmur D. S3 heart sound

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.

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A client with paroxysmal supraventricular tachycardia asks the nurse why the health care provider (HCP) is going to perform carotid sinus massage. The nurse educates the client about the treatment. Which statement by the client indicates that the teaching has been effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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