The nurse identifies the following rhythm on the cardiac monitor. Which treatment modality will the nurse anticipate for this client?
Radiofrequency ablation
Administration of amiodarone
insertion of a pacemaker
Administration of adenosine
The Correct Answer is C
A. Radiofrequency ablation: This is used to treat tachyarrhythmias such as atrial fibrillation, atrial flutter, or supraventricular tachycardia (SVT). The ECG shown does not demonstrate any tachycardic rhythm rather, it shows a bradyarrhythmia with dropped QRS complexes, which suggests a conduction block, not a reentrant circuit.
B. Administration of amiodarone: Amiodarone is primarily used for ventricular arrhythmias or atrial fibrillation. It is not effective in treating bradyarrhythmias or heart blocks such as those seen in this rhythm strip.
C. Insertion of a pacemaker: The rhythm strip shows intermittent dropped QRS complexes with consistent P waves—this is indicative of second-degree AV block, Mobitz II. This type of conduction block can progress to complete heart block and is often treated with the insertion of a permanent pacemaker to maintain cardiac output.
D. Administration of adenosine: Adenosine is used to terminate SVT by temporarily blocking AV node conduction. It is contraindicated in heart blocks, especially Mobitz II or third-degree AV block, because it can worsen the block and cause asystole.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["125"]
Explanation
Calculate the total volume to be infused in drops.
Total drops = Total volume (mL) × Drop factor (gtts/mL)
= 1000 mL × 60 gtts/mL
= 60000 gtts
Calculate the total infusion time in minutes.
Total infusion time (minutes) = Total hours × 60 minutes/hour
= 8 hours × 60 minutes/hour
= 480 minutes
Calculate the IV flow rate in drops per minute (gtts/min).
IV rate (gtts/min) = Total drops / Total infusion time (minutes)
= 60000 gtts / 480 minutes
= 125
=125 gtts/min
Correct Answer is A
Explanation
A. Review daily the necessity of the central venous catheter: One of the most effective strategies to reduce the risk of catheter-related bloodstream infections is to remove the central line as soon as it is no longer needed. Daily evaluation of necessity prevents prolonged catheter use, which significantly increases infection risk. Removing the source of potential infection is the ultimate preventative action.
B. Maintain a pressure of 300 mm Hg on the flush bag: While maintaining appropriate flush pressure is important for catheter patency and preventing blood clots, it does not play a direct role in preventing bloodstream infections. This action is more related to ensuring adequate line function rather than infection control.
C. Cleanse the insertion site daily with isopropyl alcohol: Current guidelines recommend using chlorhexidine-based solutions rather than isopropyl alcohol for skin antisepsis due to better antimicrobial efficacy. Daily site care is important, but the choice of antiseptic is critical in reducing infection risk.
D. Change the pressurized tubing system and flush bag daily: Tubing and flush systems should be changed typically every 72–96 hours unless contamination is suspected. Changing them daily is not recommended and does not provide added protection against infection it may even increase risk with unnecessary manipulation.
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