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A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

P wave touching the T wave

Midsternal chest pain

Increased urine output

Mild orthostatic hypotension

Answer and Explanation

The Correct Answer is B

A. P wave touching the T wave can indicate an issue but is less urgent than chest pain.

B. Midsternal chest pain could indicate myocardial ischemia or infarction, requiring immediate intervention.

C. Increased urine output is not an urgent concern in this context.

D. Mild orthostatic hypotension is not as urgent as chest pain.

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Correct Answer is B

Explanation

A. Adenosine 6 mg IV push: Adenosine is used for certain supraventricular tachycardias, but immediate cardioversion is the first priority for a client with atrial flutter and chest pain.

B. Immediate cardioversion: This is the correct answer. Immediate cardioversion is indicated for atrial flutter with signs of hemodynamic instability, such as chest pain and shortness of breath.

C. Adenosine 12 mg IV push: Adenosine may be used after the first dose of 6 mg if the initial dose was ineffective, but cardioversion takes precedence for unstable patients.

D. Amiodarone 150 mg bolus followed by a 24-hour drip: Amiodarone is an antiarrhythmic used for rate control or rhythm conversion but is not the first step for hemodynamically unstable clients with atrial flutter.

A. Apply a paper bag over the clients nose and mouth. B. Administer 50 mL of 20% glucose and 20 units of regular insulin. C. Administer 50 mL of sodium bicarbonate intravenously. D. Apply oxygen by mask or nasal cannula.

Correct Answer is D

Explanation

A. Appling a paper bag over the client's nose and mouth is used for hyperventilation or respiratory alkalosis, not for respiratory acidosis. In this case, it would worsen the client’s condition by increasing CO2 retention.

B. Administering 50 mL of 20% glucose and 20 units of regular insulin is appropriate for hyperkalemia or diabetic ketoacidosis, not respiratory acidosis following a seizure.

C. Administering 50 mL of sodium bicarbonate intravenously is used for severe metabolic acidosis. This client’s acidosis is primarily respiratory in origin, making this choice inappropriate.

D. Applying oxygen by mask or nasal cannula helps correct the low oxygen levels and supports respiration post-seizure.

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A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is on the progressive care unit develops atrial flutter, rate 150 with dyspnea, shortness of breath and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

Correct Answer is B

Explanation

A client has just experienced a 90-second tonic-clonic seizure and has the following arterial blood gas results: pH 7.12, HCO3 22 mEq/L, PaCO2 55 mmHg, PaO2 60 mmHg. Which intervention is the most appropriate?

Correct Answer is D

Explanation

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