A nurse is caring for a client who reports shortness of breath and heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse palpates a rapid carotid pulse with a blood pressure of 70/30, and the client reports feeling dizzy. The nurse should anticipate the need for which priority action?

Initiate external pacing.

Initiate CPR.

Defibrillation.

Synchronized cardioversion.

Answer and Explanation

The Correct Answer is D

A. External pacing is not indicated for ventricular tachycardia with a pulse. Pacing is typically used for bradyarrhythmias.
B. CPR is only necessary if the client is pulseless. Since the client has a pulse, a more appropriate intervention is needed.
C. Defibrillation is used for pulseless VT or ventricular fibrillation, but this client has a pulse and is symptomatic.
D. Synchronized cardioversion is the appropriate intervention for unstable ventricular tachycardia with a pulse. The shock is synchronized to the R wave to prevent inducing ventricular fibrillation.

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Correct Answer is A

Explanation

A. Dyspnea is the priority finding as it may indicate heart failure or pulmonary embolism, both of which are life-threatening complications of infective endocarditis.
B. Anorexia is a common symptom but is not an immediate threat to the client's condition.
C. Malaise is a general symptom of infection but does not require urgent intervention.
D. Fever is a hallmark sign of infection but is not as critical as assessing for complications such as heart failure or embolic events.

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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Naxlex Comprehensive Predictor Exams

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?

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

A nurse is caring for a heart failure client with a history of dietary noncompliance. 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 with sudden onset of chest pain, the nurse completes the electrocardiogram (ECG). The nurse understands that this client is having what type of acute coronary syndrome?

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?

A nurse is caring for a client admitted with hypertensive emergency. The nurse is aware the treatment goals for the patient include which of the following?

A nurse is caring for a client diagnosed with heart failure and atrial fibrillation. The client reports feeling palpitations and shortness of breath. The nurse is aware that clients with atrial fibrillation are at risk for which complication?

A nurse is caring for a client with right-sided heart failure. Which of the following symptoms should the nurse include in teaching the client about signs of worsening heart failure? (SELECT ALL THAT APPLY)

A client has undergone diagnostic testing and received a diagnosis of sinus bradycardia. Which interventions are most appropriate and should be included in the client's plan of care? (SELECT ALL THAT APPLY)