The nurse is assigned to provide care for the following clients. Which client should the nurse assess first?
A client who received elective cardioversion 2 hour ago with a heart rate (HR) of 105 bpm.
A client who was given IV amiodarone on the prior shift due to the client's implantable cardioverter defibrillator (ICD) firing twice in 6 hours.
A client who is returned from an electrophysiology (EP) procedure 2 hours ago complaining of constipation.
A client who is diagnosed with new onset of atrial fibrillation requiring scheduled Cardizem.
The Correct Answer is B
A. A HR of 105 bpm after elective cardioversion is mildly elevated and not immediately life-threatening.
B. A client with an ICD that has fired twice in 6 hours and is receiving IV amiodarone is at high risk for life-threatening arrhythmias and requires immediate assessment.
C. Constipation post-EP procedure is uncomfortable but not an urgent concern.
D. New-onset atrial fibrillation requires monitoring and rate control but is generally less urgent than a client with recurrent ICD discharges.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Dopamine primarily increases heart rate and contractility (inotropy), but at higher doses it also causes vasoconstriction, which may increase afterload—not desirable in a patient with heart failure and hypotension.
B. Epinephrine increases both heart rate and systemic vascular resistance, which could increase afterload and worsen cardiac output in heart failure.
C. Vasopressin is a potent vasoconstrictor, which raises vascular resistance and may increase afterload, potentially worsening heart failure.
D. Diltiazem is a calcium channel blocker that decreases systemic vascular resistance by dilating peripheral arteries, thereby reducing afterload. Lower afterload improves cardiac output in patients with heart failure while also helping to manage blood pressure.
Correct Answer is B
Explanation
A. A decrease in premature contractions is not the primary goal of atropine; it specifically targets bradycardia.
B. Atropine works by blocking parasympathetic stimulation to the heart, which increases the heart rate. An increase in heart rate to within normal limits (60–100 bpm) directly indicates the medication is effective.
C. Resolution of symptoms may occur as a result of the increased heart rate, but it is an indirect measure and not the primary indicator of drug effectiveness.
D. Blood pressure may improve secondary to heart rate normalization, but it is not the most direct or immediate indicator of atropine efficacy.
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