A nurse is reviewing a client's cardiac monitor. Which of the following findings should the nurse identify as an indication for synchronized cardioversion?

Asystole

Ventricular fibrillation

Pulseless ventricular tachycardia

Atrial fibrillation

Answer and Explanation

The Correct Answer is D

A. Asystole: Synchronized cardioversion is ineffective for asystole because there is no electrical activity to reset. The appropriate intervention for asystole is immediate CPR and administration of epinephrine.

B. Ventricular fibrillation: Defibrillation, not synchronized cardioversion, is the appropriate treatment for ventricular fibrillation because it is a pulseless, chaotic rhythm that requires immediate high-energy shocks.

C. Pulseless ventricular tachycardia: Pulseless ventricular tachycardia is treated with defibrillation rather than synchronized cardioversion, as there is no coordinated cardiac activity to synchronize with. CPR and advanced cardiac life support (ACLS) protocols should be initiated.

D. Atrial fibrillation: Synchronized cardioversion is indicated for atrial fibrillation, particularly when it is associated with hemodynamic instability. Cardioversion helps restore a normal sinus rhythm by delivering a shock synchronized to the R wave of the QRS complex.

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Correct Answer is B

Explanation

A. Wears an N95 mask when providing wound care: MRSA is transmitted via direct contact rather than airborne particles, so an N95 mask is unnecessary unless the client has a secondary airborne infection like tuberculosis. Standard contact precautions, including gloves and gowns, are sufficient to prevent transmission.

B. Wears clean gloves when caring for the client: MRSA requires contact precautions, which include wearing gloves when touching the client or contaminated surfaces. Gloves help prevent the spread of bacteria, particularly from wound drainage, body fluids, or contaminated equipment.

C. Remains 3 feet away from the client: MRSA does not require droplet precautions, which would necessitate maintaining a distance of 3 feet. Instead, direct skin-to-skin contact or contact with contaminated surfaces is the primary mode of transmission, requiring gloves and gowns rather than distance.

D. Disposes of isolation gown outside of the client's room: Isolation gowns should be removed inside the client’s room to prevent cross-contamination. Removing the gown before exiting the room reduces the risk of spreading MRSA to other areas and healthcare personnel.

A. Genital herpes B. Varicella zoster C. Tuberculosis D. Clostridium difficile

Correct Answer is C

Explanation

A. Genital herpes: Herpes simplex virus (HSV) is a common sexually transmitted infection, but it is not a nationally notifiable disease. Reporting is not mandatory in most jurisdictions, although counseling and partner notification are recommended.

B. Varicella zoster: Chickenpox (primary varicella infection) is reportable in some states, but herpes zoster (shingles) is generally not required to be reported. However, outbreaks in certain settings, such as schools or healthcare facilities, may need notification.

C. Tuberculosis: Tuberculosis is a highly contagious airborne disease that requires mandatory reporting to public health authorities. Reporting ensures contact tracing, outbreak control, and public health interventions to prevent further transmission.

D. Clostridium difficile: While Clostridium difficile infections are of significant concern in healthcare settings, they are not universally reportable to the local health department. Infection control measures are implemented within facilities, but routine reporting is not always required.

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A nurse is reviewing a client's cardiac monitor. Which of the following findings should the nurse identify as an indication for synchronized cardioversion?

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