After teaching a client who has an implantable cardioverter- defibrillator (ICD), a nurse assesses the client's understanding. Which statement by the client indicates correct understanding of the teaching?

"I will avoid sources of strong electromagnetic fields."

"Now I can discontinue my antidysrhythmic medication."

"I would participate in a strenuous exercise program."

"I would wear a snug-fitting shirt over the ICD."

Answer and Explanation

The Correct Answer is A

A. Clients with ICDs should avoid strong electromagnetic fields, which can interfere with the device’s function. This is crucial for safety.

B. Discontinuing antidysrhythmic medication is not recommended unless instructed by the healthcare provider, as it could increase the risk of arrhythmias.

C. Strenuous exercise may be too strenuous for someone with an ICD and could increase the risk of arrhythmias or lead to ICD activation.

D. A snug-fitting shirt is generally not recommended because it may place pressure on the ICD site and cause discomfort.

Nursing Test Bank

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Correct Answer is B

Explanation

A. Lantus insulin does not directly affect potassium levels in the same way that digoxin does.

B. A potassium level of 3.0 mEq/L is low, and digoxin toxicity can occur when potassium levels are low, leading to an increased risk of arrhythmias. This requires immediate attention to avoid serious complications.

C. Metoprolol is a beta-blocker that does not directly cause hypokalemia and is less of an immediate concern.

D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that could affect kidney function but does not directly impact potassium levels as significantly as digoxin.

A. Apply a paper bag over the clients nose and mouth. B. Administer 50 mL of 20% glucose and 20 units of regular insulin. C. Administer 50 mL of sodium bicarbonate intravenously. D. Apply oxygen by mask or nasal cannula.

Correct Answer is D

Explanation

A. Appling a paper bag over the client's nose and mouth is used for hyperventilation or respiratory alkalosis, not for respiratory acidosis. In this case, it would worsen the client’s condition by increasing CO2 retention.

B. Administering 50 mL of 20% glucose and 20 units of regular insulin is appropriate for hyperkalemia or diabetic ketoacidosis, not respiratory acidosis following a seizure.

C. Administering 50 mL of sodium bicarbonate intravenously is used for severe metabolic acidosis. This client’s acidosis is primarily respiratory in origin, making this choice inappropriate.

D. Applying oxygen by mask or nasal cannula helps correct the low oxygen levels and supports respiration post-seizure.

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Test Name	Results	Reference Range
WBC	12, 000	4, 000- 11, 000
Na+	149 mEq/L	135-145 mEq/L
K+	5.0 mEq/L	3.5- 5.0 mEq/L
Cl-	110 mEq/L	96-106 mEq/L
pH	7.34	7.35-7.45
PaCO2	34 mmHg	35- 45 mmHg
PaO2	78 mm Hg	80-100 mmHg
HCO3	21 mEq/L	22- 26 mEq/L

After teaching a client who has an implantable cardioverter- defibrillator (ICD), a nurse assesses the client's understanding. Which statement by the client indicates correct understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the client is on which medication?

Correct Answer is B

Explanation

A client has just experienced a 90-second tonic-clonic seizure and has the following arterial blood gas results: pH 7.12, HCO3 22 mEq/L, PaCO2 55 mmHg, PaO2 60 mmHg. Which intervention is the most appropriate?

Correct Answer is D

Explanation

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