A nurse is caring for a client who suddenly develops atrial fibrillation with a ventricular rate of 150 beats per minute. The nurse should assess the client for which of the following priority signs and symptoms associated with this dysrhythmia?

Nausea and vomiting

Hypertension and headache

Flattened neck veins

Hypotension and dizziness

Answer and Explanation

The Correct Answer is D

Choice A reason: Nausea and vomiting can occur in cardiac conditions due to reduced perfusion to the gastrointestinal system. However, in atrial fibrillation with a rapid ventricular rate, the priority is assessing for symptoms of reduced cardiac output, such as hypotension and dizziness, which are more immediate and life-threatening.

Choice B reason: Hypertension and headache are not typical of rapid atrial fibrillation, which usually causes reduced cardiac output due to ineffective atrial contractions. These symptoms are more associated with hypertensive crises or other conditions, making them less relevant for this dysrhythmia.

Choice C reason: Flattened neck veins suggest hypovolemia or low venous pressure, not typical in acute atrial fibrillation, where jugular vein distension may occur due to heart failure. Hypotension and dizziness are more direct indicators of compromised cardiac output in this scenario.

Choice D reason: Rapid atrial fibrillation impairs atrial filling, reducing cardiac output and causing hypotension. Dizziness results from decreased cerebral perfusion due to low blood pressure. These are critical symptoms to assess, as they indicate hemodynamic instability, requiring immediate intervention to prevent further complications.

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Correct Answer is D

Explanation

Choice A reason: Resuming vigorous activity like tennis one week post-pacemaker insertion risks lead dislodgement, as the device requires time to stabilize. Arm movements in tennis, especially overhead swings, can disrupt the pacemaker leads, making this advice unsafe and inappropriate.

Choice B reason: Suggesting hockey or skating as alternatives is incorrect, as these activities also involve significant physical exertion and risk of trauma to the pacemaker site. Additionally, delaying until fall is arbitrary, and these sports do not reduce the risk of lead dislodgement compared to tennis.

Choice C reason: Substituting tennis with basketball or football is inappropriate, as these contact sports pose a higher risk of trauma to the pacemaker site, potentially causing device malfunction or lead dislodgement. These activities are not safer alternatives and could exacerbate complications.

Choice D reason: Restricting arm movement above the head for two weeks post-pacemaker insertion prevents lead dislodgement, as the leads need time to anchor in the heart tissue. Tennis involves vigorous arm motions, so canceling the tournament is necessary to ensure device stability and client safety.

A. I will review the ingredients before using salt substitutes. B. If I feel unwell, it is okay that I miss a dose. C. It is okay if I feel dizzy when I stand after sitting for a while. D. It is okay to incorporate an unlimited amount of potatoes, bananas, and oranges in my diet.

Correct Answer is A

Explanation

Choice A reason: Lisinopril can cause hyperkalemia due to reduced potassium excretion. Salt substitutes often contain potassium chloride, which can exacerbate this risk. Reviewing ingredients prevents excessive potassium intake, which could lead to dangerous cardiac arrhythmias, demonstrating proper understanding of dietary precautions.

Choice B reason: Missing a dose of lisinopril if feeling unwell is dangerous, as it may worsen hypertension or heart failure. Consistent dosing is critical to maintain therapeutic effects, and this statement indicates a misunderstanding requiring further teaching on medication adherence.

Choice C reason: Dizziness upon standing (orthostatic hypotension) is a side effect of lisinopril due to vasodilation and reduced blood pressure. Accepting this as normal without reporting it could delay intervention for excessive hypotension, indicating a need for further education.

Choice D reason: Unlimited intake of high-potassium foods like potatoes, bananas, and oranges can lead to hyperkalemia in clients taking lisinopril, risking cardiac arrhythmias. This statement reflects a lack of understanding of dietary potassium restrictions, necessitating further teaching on safe dietary practices.

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A nurse is caring for a client who suddenly develops atrial fibrillation with a ventricular rate of 150 beats per minute. The nurse should assess the client for which of the following priority signs and symptoms associated with this dysrhythmia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in one week. What teaching should the nurse provide to the client related to this activity?

Correct Answer is D

Explanation

The nurse is providing discharge instructions to a client who is prescribed lisinopril, an ACE inhibitor. Which statement by the client demonstrates proper understanding of the discharge instructions?

Correct Answer is A

Explanation

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