A nurse is caring for a patient with atrial fibrillation. In addition to an antidysrhythmic, what medication does the nurse plan to administer?

Warfarin

Atropine

Dobutamine

Magnesium sulfate

Answer and Explanation

The Correct Answer is A

Choice A reason: Warfarin is an anticoagulant commonly used in patients with atrial fibrillation to prevent the formation of blood clots. Atrial fibrillation increases the risk of stroke due to the potential for blood clots forming in the heart and traveling to the brain. Warfarin helps reduce this risk by thinning the blood and preventing clot formation.

Choice B reason: Atropine is used to treat bradycardia (slow heart rate) and is not typically used for patients with atrial fibrillation. Its primary function is to increase the heart rate by blocking the vagus nerve's effects on the heart. In the context of atrial fibrillation, anticoagulation is more crucial to prevent complications like stroke.

Choice C reason: Dobutamine is an inotropic agent used to increase cardiac output in patients with heart failure or cardiogenic shock. It is not used for managing atrial fibrillation. Dobutamine works by stimulating the heart to pump more effectively but does not address the risks associated with atrial fibrillation, such as blood clot formation.

Choice D reason: Magnesium sulfate is used to treat various conditions, including torsades de pointes (a type of abnormal heart rhythm) and severe asthma attacks. It is not typically used for atrial fibrillation. The focus in atrial fibrillation management is on controlling the heart rate or rhythm and preventing thromboembolic complications with anticoagulation therapy.

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Correct Answer is D

Explanation

Choice A reason: A decreased heart rate is not a typical outcome of ACE inhibitor therapy. ACE inhibitors primarily work by relaxing blood vessels, which lowers blood pressure. They do not directly affect the heart rate. While some blood pressure medications can influence heart rate, this is not a common effect of ACE inhibitors like lisinopril.

Choice B reason: A decrease in chest pain is also not a primary outcome of ACE inhibitor therapy. While lowering blood pressure can help reduce the workload on the heart and potentially decrease angina (chest pain), this is more of an indirect effect. ACE inhibitors are primarily used for hypertension and heart failure, not specifically for pain relief.

Choice C reason: Hypokalemia, or low potassium levels, is not an expected outcome of taking an ACE inhibitor. In fact, ACE inhibitors can lead to hyperkalemia (high potassium levels) because they decrease aldosterone production, which causes the body to retain potassium. Patients on ACE inhibitors are often monitored for signs of hyperkalemia rather than hypokalemia.

Choice D reason: The correct and expected outcome of taking lisinopril, an ACE inhibitor, is decreased blood pressure. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing levels of angiotensin II, ACE inhibitors help relax blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood. This is the primary therapeutic effect of the medication.

A. Patient with urine output of 40 mL/hr for the last hour. B. Patient with a blood pressure change of 128/74 to 110/88 mmHg. C. Patient with oxygen saturation maintained at 94%. D. Patient with a pulse change of 100 to 88 beats/min.

Correct Answer is B

Explanation

Choice A reason: A urine output of 40 mL/hr is within the acceptable range, as normal urine output is typically around 30-50 mL/hr. While it should be monitored, it does not indicate an immediate life-threatening issue requiring urgent assessment.

Choice B reason: A blood pressure change from 128/74 to 110/88 mmHg may indicate potential hemodynamic instability. Although the systolic blood pressure has decreased, the diastolic pressure has increased, which can be concerning. This patient may be at risk for developing more significant blood pressure changes or other complications, making this situation the highest priority for assessment.

Choice C reason: An oxygen saturation level of 94% is generally considered acceptable. While it is on the lower end of the normal range, it does not indicate an immediate life-threatening condition. Continuous monitoring is important, but it is not the most urgent situation compared to the blood pressure change.

Choice D reason: A pulse change from 100 to 88 beats/min represents a decrease in heart rate but remains within the normal range for adult heart rate (60-100 beats/min). While this change should be noted and monitored, it is not as urgent as the blood pressure change that may indicate hemodynamic instability.

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A nurse is caring for a patient with atrial fibrillation. In addition to an antidysrhythmic, what medication does the nurse plan to administer?

Nursing Test Bank

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Correct Answer is D

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