Following morning assessments, the registered nurse may delegate which of the following clients with a dysrhythmia to a licensed practical nurse? A client with
sinus bradycardia.
ventricular fibrillation.
second-degree AV block type II (Mobitz II).
ventricular tachycardia.
The Correct Answer is A
A. Sinus bradycardia: Sinus bradycardia is often stable and asymptomatic, especially if the patient is hemodynamically stable and not experiencing syncope, chest pain, or hypotension. A licensed practical nurse (LPN) can safely monitor vital signs, assess for symptoms, and report any changes to the RN while providing routine care and medication administration.
B. Ventricular fibrillation: Ventricular fibrillation is a life-threatening arrhythmia requiring immediate defibrillation and advanced cardiac life support. This patient requires constant, high-acuity monitoring and interventions that cannot be delegated to an LPN.
C. Second-degree AV block type II (Mobitz II): Mobitz II is high-risk for progression to complete heart block and sudden cardiac arrest. Continuous ECG monitoring, preparation for pacing, and prompt RN interventions are required, making delegation unsafe.
D. Ventricular tachycardia: Ventricular tachycardia, especially if symptomatic or unstable, is a potentially fatal dysrhythmia. It requires rapid assessment, advanced interventions, and potential defibrillation, all of which must be managed by an RN.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Magnesium: Magnesium is primarily used to treat torsades de pointes or severe hypomagnesemia. It is not indicated for symptomatic bradycardia and would not address inadequate heart rate or perfusion in this scenario.
B. Atropine: Atropine is the first-line medication for symptomatic bradycardia. It works by blocking parasympathetic stimulation via the vagus nerve, increasing the firing rate of the sinoatrial node and improving conduction through the atrioventricular node, which raises the heart rate and improves cardiac output.
C. Epinephrine: Epinephrine can be used for bradycardia if atropine is ineffective, particularly in advanced cardiac life support. However, it is typically considered a second-line agent because of its systemic adrenergic effects, including increased myocardial oxygen demand and potential arrhythmogenicity.
D. Sodium bicarbonate: Sodium bicarbonate is used to correct severe metabolic acidosis during cardiac arrest or in specific toxicologic emergencies. It does not directly treat bradycardia and is not part of first-line therapy for symptomatic low heart rate.
Correct Answer is B
Explanation
Rhythm: Sinus, regular
Rate: 50 b/min
P wave: Present, normal
PR interval: Normal 0.2 seconds
QRS: Narrow
Rhythm interpretation: Sinus bradycardia
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