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A nurse is caring for a client who is in pulseless ventricular tachycardia (V-Tach). The nurse recognizes the need for which priority intervention?

Synchronized Cardioversion

Repeat electrocardiogram (ECG)

Assessment of blood pressure

Immediate Defibrillation

Answer and Explanation

The Correct Answer is D

Rationale:

A. Synchronized cardioversion is not appropriate for pulseless ventricular tachycardia.

B. A repeat ECG is not necessary for pulseless ventricular tachycardia.

C. Assessment of blood pressure is not the priority in pulseless ventricular tachycardia.

D. Immediate defibrillation is the priority in pulseless ventricular tachycardia to restore a perfusing rhythm.

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Correct Answer is C

Explanation

Rationale:

A. Diminished breath sounds are not typically associated with a pericardial effusion.

B. Increased blood pressure is not typically associated with a pericardial effusion but it can instead result in hypotension due to decreased cardiac output due to compression of the heart by the accumulated fluid.

C. The heart sounds may become faint or distant due to fluid accumulation around the heart.

D. A new systolic murmur may indicate a pericardial effusion and should be further evaluated.

A. "The next pacemaker check will be when the batteries need to be replaced." B. "My pacemaker will need reprogramming if I stand too close to a microwave oven." C. "I will take my pulse weekly." D. "The pacemaker can be checked from home by using the telephone."

Correct Answer is D

Explanation

A. Regular pacemaker checks are scheduled periodically, not only when the battery needs replacement.
B. Modern pacemakers are well-shielded and are not affected by household microwaves.
C. Clients should check their pulse daily to ensure proper pacemaker function, not just weekly.
D. Many pacemakers can be checked remotely using telephone or wireless technology, allowing for convenient monitoring.

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A nurse is caring for a client who is in pulseless ventricular tachycardia (V-Tach). The nurse recognizes the need for which priority intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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