A nurse is caring for a client who develops third-degree heart block with a heart rate of 30/min. Which of the following actions should the nurse take?

Administer digoxin by IV bolus.

Instruct the client to perform the Valsalva maneuver.

Prepare the client for temporary pacing

Perform carotid sinus massage

Answer and Explanation

The Correct Answer is C

A. Digoxin slows conduction through the AV node and can worsen heart block. It is contraindicated in clients with third-degree (complete) heart block.
B. The Valsalva maneuver can increase vagal tone and further slow the heart rate, making it inappropriate and potentially dangerous in complete heart block.
C. Preparing the client for temporary pacing is the correct and immediate intervention for symptomatic third-degree heart block with a very slow heart rate (30/min), as this condition results in ineffective atrial-to-ventricular conduction and may lead to severe bradycardia and hemodynamic instability.
D. Carotid sinus massage slows the heart rate and is used to treat supraventricular tachycardias, not bradyarrhythmias like third-degree heart block.

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Correct Answer is ["B","E"]

Explanation

A. Placing a tongue blade at the bedside is inappropriate and outdated. It should never be inserted into a client's mouth during a seizure due to the risk of injury.
B. Dimming overhead lights helps reduce environmental stimuli, which can lower the risk of triggering seizures in clients with meningitis.
C. Ambulating every 4 hours is not appropriate during the acute phase of meningitis when the client is at risk for seizures and may have decreased neurological function.
D. Applying a warming blanket is unnecessary unless the client is hypothermic. Meningitis does not typically cause hypothermia.
E. Having suction equipment at the bedside is essential to maintain airway patency and prevent aspiration during or after a seizure.

A. Bilateral coarse, crackle breath sounds B. Vesicular breath sounds over the peripheral lung fields C. Blood pressure 100/70 mm Hg D. Potassium 3.2 mEq/L (3.5 mEq/L to 5.0 mEq/L)

Correct Answer is A

Explanation

A. Bilateral coarse crackles are a key sign of pulmonary edema, indicating fluid overload in the lungs. Furosemide is a loop diuretic used to remove excess fluid, making this finding an appropriate indication for the prescription.
B. Vesicular breath sounds are normal lung sounds heard over the peripheral lung fields and do not suggest fluid overload or the need for diuretic therapy.
C. A blood pressure of 100/70 mm Hg is within a safe range, but on its own does not justify the use of furosemide. However, it is important to monitor blood pressure closely during diuretic therapy to avoid hypotension.
D. A potassium level of 3.2 mEq/L is below normal, and since furosemide can cause further potassium loss, this would typically require correction or supplementation before or during diuretic therapy—not an indication that the drug is appropriate as-is.

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A nurse is caring for a client who develops third-degree heart block with a heart rate of 30/min. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is experiencing seizures secondary to meningitis. Which of the following interventions should the nurse Include in the plan of care? (Select all that apply.)

Correct Answer is ["B","E"]

Explanation

A nurse is caring for a client who has pulmonary edema and a new prescription for furosemide 40 mg IV twice daily. Which of the following client findings indicates the prescription is appropriate?

Correct Answer is A

Explanation

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