A client's EKG rhythm converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV Heparin and Diltiazem are initiated. The nurse caring for the client understands that the priority goal of treatment is what?
Improve oxygenation
Decrease SA node conduction
Maintain anticoagulation
Control ventricular heart rate
The Correct Answer is D
A. Oxygenation is not compromised; respiratory status is normal, so improving oxygenation is not the immediate priority.
B. Diltiazem works on the AV node, not the SA node, to slow conduction.
C. Anticoagulation with heparin prevents thromboembolic complications but is not the immediate priority in acute atrial fibrillation with rapid ventricular response.
D. Controlling the ventricular rate is the priority to stabilize hemodynamics, reduce myocardial oxygen demand, and prevent complications such as hypotension or heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Third-degree AV block is a bradyarrhythmia and typically has a wide QRS due to ventricular escape rhythm.
B. Ventricular tachycardia originates in the ventricles, producing a wide QRS complex.
C. Ventricular fibrillation is characterized by chaotic ventricular activity with no discernible QRS complexes.
D. Supraventricular tachycardia originates above the ventricles (atria or AV node) and produces a narrow QRS complex, making it the classic example of narrow complex tachycardia.
Correct Answer is C
Explanation
A. Atrophy of the ventricles does not occur in DCM; the ventricles are weakened and dilated, not atrophied.
B. Dilation of the atria with ventricular hypertrophy is more characteristic of restrictive or hypertrophic cardiomyopathy, not DCM.
C. Dilated cardiomyopathy primarily involves dilation of the ventricles with thinning of the ventricular walls and impaired systolic function, without compensatory hypertrophy.
D. Dilation and hypertrophy of all four chambers is more characteristic of advanced or biventricular cardiomyopathy but is not the classic finding in typical DCM.
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