Mr. B has been admitted to the CCU with an acute onset of atrial fibrillation with a ventricular response of 155 bpm, respirations 28, BP 100/60, skin warm and dry, and he is complaining of feeling weak with his heart racing. The purpose of the anticoagulants is:

all of these

reduce thromboembolic complications

convert the rhythm to a normal sinus rhythm

control the ventricular response

Answer and Explanation

The Correct Answer is B

A. all of these: Anticoagulants do not convert atrial fibrillation to normal sinus rhythm, nor do they directly control the ventricular rate. Their role is specific to preventing thromboembolic events, so selecting “all of these” would be inaccurate in this context.

B. reduce thromboembolic complications: Anticoagulants are prescribed in atrial fibrillation to prevent clot formation in the atria, particularly the left atrial appendage. Atrial fibrillation causes stasis of blood, which significantly increases the risk of stroke or systemic embolism. The medication’s primary purpose is prophylactic, reducing morbidity and mortality from thromboembolic events.

C. convert the rhythm to a normal sinus rhythm: Rhythm conversion requires antiarrhythmic medications or electrical cardioversion, not anticoagulants. While anticoagulants may be continued before and after cardioversion to reduce stroke risk, they do not restore sinus rhythm on their own.

D. control the ventricular response: Ventricular rate control is achieved with beta-blockers, calcium channel blockers, or digoxin. Anticoagulants have no effect on heart rate or AV nodal conduction, so they do not address the rapid ventricular response seen in atrial fibrillation.

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Correct Answer is A

Explanation

A. Pulmonary embolism: Atrial fibrillation causes ineffective atrial contractions, which can lead to blood stasis and thrombus formation, particularly in the left atrial appendage. If a thrombus dislodges, it can travel to the lungs (pulmonary embolism) or brain (stroke). Monitoring for signs such as sudden shortness of breath, chest pain, or hemoptysis is essential for early detection and intervention.

B. Peripheral vascular disease: Peripheral vascular disease is primarily caused by atherosclerosis and is not a direct complication of atrial fibrillation. While AF and PVD can coexist, AF does not specifically increase the risk for PVD.

C. Hypertension: Hypertension is a risk factor for developing atrial fibrillation but is not a complication resulting from AF. Blood pressure management is important but is not the immediate complication to monitor for in newly diagnosed AF.

D. Bradycardia: Atrial fibrillation is usually associated with a rapid and irregular ventricular response rather than bradycardia. While some treatments (e.g., beta-blockers or calcium channel blockers) may induce bradycardia, it is not a direct complication of the arrhythmia itself.

A. Keep the client NPO after midnight. B. Wash the skin with plain water before placing the electrodes. C. Administer an analgesic prior to the procedure. D. Instruct the client not talk during the test. E. Inspect the electrode pads.

Correct Answer is ["B","D","E"]

Explanation

A. Keep the client NPO after midnight: Fasting is not required for a standard ECG. The procedure is noninvasive, quick, and does not involve sedation or contrast, so keeping the client NPO is unnecessary and does not impact the quality of the ECG recording.

B. Wash the skin with plain water before placing the electrodes: To ensure a clean signal and prevent "artifact" (electrical interference), the skin should be cleaned with soap and water or alcohol prep pads to remove body oils and dead skin cells.

C. Administer an analgesic prior to the procedure: ECG placement is painless, so analgesics are not needed. Administering medication unnecessarily could expose the client to side effects without benefit and is not standard practice.

D. Instruct the client not to talk during the test: Talking or moving during the ECG can create artifacts on the tracing that may obscure the rhythm, particularly in atrial fibrillation. Instructing the client to remain still and quiet helps ensure a clear, interpretable recording.

E. Inspect the electrode pads: Checking the electrode pads for damage, dryness, or expiration ensures proper adhesion and conductivity. Faulty electrodes can produce poor-quality tracings and lead to misinterpretation of the cardiac rhythm.

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Mr. B has been admitted to the CCU with an acute onset of atrial fibrillation with a ventricular response of 155 bpm, respirations 28, BP 100/60, skin warm and dry, and he is complaining of feeling weak with his heart racing. The purpose of the anticoagulants is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new diagnosis of atrial fibrillation. The nurse should instruct the client to monitor for which of the following complications?

Correct Answer is A

Explanation

A nurse is assisting with obtaining an electrocardiogram (ECG) for a client who has atrial fibrillation. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

The nurse is analyzing the ECG strip of a 40 year old female and notes that the patient has a sinus arrhythmia. The nurse:

What is the most likely rhythm interpretation?

What is the most likely rhythm interpretation?

A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify?

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority?

What is the most likely rhythm interpretation?

A nurse is caring for a client who just had a cardiac catheterization. Which of the following nursing interventions should the nurse include in the client's plan of care? (Select all that apply.)

The nurse's responsibilities is preparing to defibrillate a patient include: