A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Petechiae

Slowing pulse rate

Confusion

Pruritus

Answer and Explanation

The Correct Answer is A

Rationale:

A. Petechiae are small, pinpoint red or purple spots on the skin that may indicate bleeding or thrombocytopenia, which can be a side effect of heparin therapy.

B. Slowing pulse rate is not typically associated with heparin therapy.

C. Confusion is not typically associated with heparin therapy.

D. Pruritus (itching) is not typically associated with heparin therapy.

Nursing Test Bank

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Correct Answer is D

Explanation

Rationale:

A. Amiodarone administration is used for the treatment of ventricular fibrillation (VF) and ventricular tachycardia (VT) that is unresponsive to cardioversion.

B. Synchronized Cardioversion is used for the treatment of atrial fibrillation (AF), atrial flutter (AFL), and unstable ventricular tachycardia (VT).

C. Epinephrine administration is part of the ACLS algorithm for the treatment of VF and pulseless VT. It is given after defibrillation.

D. Defibrillation is the immediate treatment for ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT).

A. Radiofrequency catheter ablation B. CPR C. Defibrillation D. Synchronized cardioversion

Correct Answer is D

Explanation

A. Radiofrequency catheter ablation is a long-term treatment for recurrent VT, not an immediate intervention.
B. CPR is indicated for pulseless VT, but this client has a carotid pulse.
C. Defibrillation is used for pulseless VT or ventricular fibrillation, but this client is still perfusing.
D. Synchronized cardioversion is the appropriate treatment for unstable VT with a pulse, as it delivers a timed shock to restore normal rhythm.

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A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with chest pain who suddenly becomes unresponsive. The client is pulseless, and apneic. The code team places the client on the monitor which indicates ventricular fibrillation, what is the next priority action?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

Identify the following Cardiac Rhythm:

A nurse is assessing a patient with known mitral valve regurgitation. The nurse should expect to hear which of the following heart sounds?

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A nurse is caring for a heart failure client with a history of dietary non compliance. The nurse suspects the client has fluid volume overload. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY))

A nurse is caring for a client diagnosed with infective endocarditis. The nurse is aware that which of the following is the priority assessment finding for this patient?

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