A nurse prepares a client for an emergent aortic aneurysm open repair. The client states, "I am afraid I might die." What is the nurse's best response?
Tell me more about your concerns about the surgery.
Would you like to speak with a chaplain prior to surgery?
What support systems do you have to assist you?
This is a routine surgery and the risk of death is very low.
The Correct Answer is A
A. Tell me more about your concerns about the surgery: This response uses therapeutic communication by encouraging the client to express feelings and fears. It is open-ended, acknowledges the client’s anxiety, and allows the nurse to assess specific concerns.
B. Would you like to speak with a chaplain prior to surgery: While spiritual support may be helpful, this option changes the focus away from exploring the client’s expressed fear. The nurse should first assess the client’s concerns before offering additional resources.
C. What support systems do you have to assist you: This question may be appropriate later, but it does not directly address the client’s immediate fear of dying. The priority is to explore the expressed anxiety.
D. This is a routine surgery and the risk of death is very low: Providing false reassurance dismisses the client’s feelings and may undermine trust. Emergent aortic aneurysm repair is a high-risk surgery, so minimizing the risk is inappropriate and nontherapeutic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The rhythm strip shown in A exhibits a regular underlying rhythm interrupted by a Premature Ventricular Contraction (PVC), which is a wide, bizarre QRS complex occurring earlier than expected. While PVCs can cause palpitations, they do not typically present as a sustained "rapid, irregular" heart rate with a total absence of P-waves across the entire strip.
B. The rhythm strip in B represents Atrial Fibrillation (AFib), characterized by a "normally irregular" ventricular response and the replacement of distinct P-waves with chaotic fibrillatory waves. In AFib, the atria quiver rather than contract, leading to a significant pulse deficit because not every electrical impulse results in a ventricular contraction strong enough to produce a peripheral pulse.
Correct Answer is A
Explanation
A. Atropine: The telemetry strip shows sinus bradycardia, indicated by a regular rhythm with a rate below 60 beats per minute and normal P waves preceding each QRS complex. Atropine is the first-line medication for symptomatic bradycardia because it blocks vagal stimulation of the heart, increasing the heart rate and improving perfusion.
B. Magnesium: Magnesium is primarily used to treat torsades de pointes, a specific form of polymorphic ventricular tachycardia, and is not indicated for sinus bradycardia. Administering magnesium in bradycardia would not address the underlying slowed conduction.
C. Adenosine: Adenosine is used to terminate paroxysmal supraventricular tachycardia (PSVT) by transiently blocking AV nodal conduction. It is not appropriate for bradycardia, as it can further decrease heart rate or cause transient asystole.
D. Epinephrine: Epinephrine is used in advanced cardiac life support (ACLS) for cardiac arrest or severe bradycardia unresponsive to atropine. While it can increase heart rate and contractility, atropine is the first-line agent for symptomatic sinus bradycardia before initiating epinephrine.
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