A nurse is caring for a client who is ordered Potassium 40 mEq IV. On hand is Potassium Chloride 20 mEq/mL. What is the nurse’s next action?

Mix potassium in 1 liter of normal saline.

Call the physician for order clarification.

Prepare 20 mEq of Potassium to give IV push.

Give the medication as ordered.

Answer and Explanation

The Correct Answer is B

A. While potassium is typically diluted in IV fluids, the concentration and infusion rate must be clarified before administration. A standard dilution is 10 mEq in 100 mL or 40 mEq in 1L, but this must be verified.
B. Calling the physician for clarification is the safest step. IV potassium should never be given undiluted or as an IV push due to the risk of fatal cardiac arrhythmias.
C. IV push potassium is never appropriate as it can cause cardiac arrest.
D. Administering the undiluted 20 mEq/mL solution is dangerous and requires proper dilution before administration.

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Correct Answer is A

Explanation

A. Defibrillation is the priority intervention for pulseless ventricular tachycardia, as it can restore a normal rhythm. It should be performed as soon as possible.
B. Synchronized cardioversion is used for hemodynamically unstable tachyarrhythmias with a pulse, not for pulseless V-Tach.
C. CPR should be initiated if a defibrillator is not immediately available, but defibrillation is the definitive treatment.
D. Repeating an ECG does not address the immediate life-threatening situation.

A. First-degree AV block B. Sinus tachycardia C. Atrial fibrillation D. Sinus bradycardia

Correct Answer is C

Explanation

A. First-degree AV block is characterized by a prolonged PR interval but does not typically present with irregular palpitations or a pulse deficit.
B. Sinus tachycardia causes a rapid but regular rhythm, whereas atrial fibrillation is irregularly irregular.
C. Atrial fibrillation is the correct answer. It is characterized by an irregular heart rate, absence of distinct P waves on an ECG, and a pulse deficit due to ineffective atrial contractions leading to incomplete ventricular filling.
D. Sinus bradycardia presents as a slow, regular heart rate rather than a rapid, irregular rhythm with a pulse deficit.

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A nurse is caring for a client who is ordered Potassium 40 mEq IV. On hand is Potassium Chloride 20 mEq/mL. What is the nurse’s next action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in pulseless ventricular tachycardia (V-Tach). The nurse recognizes the need for which priority intervention?

Correct Answer is A

Explanation

A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?

Correct Answer is C

Explanation

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