The nurse is caring for a client during a cardiac arrest. The monitor displays the rhythm below. Which intervention should the nurse perform at this time?
Administer amiodarone 200 mg IV push
Defibrillate the client using 200 joules
CPR until the physician stops the code
Administer adenosine 12 mg IV push
The Correct Answer is C
A. Administer amiodarone 200 mg IV push: Amiodarone is used for shockable rhythms like ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) that are refractory to defibrillation. The rhythm on the monitor is asystole, which is non-shockable, and amiodarone is not indicated here.
B. Defibrillate the client using 200 joules: Defibrillation is only appropriate for shockable rhythms such as VF or pulseless VT. Asystole is not shockable, and defibrillation in this rhythm would be ineffective and inappropriate.
C. CPR until the physician stops the code: The rhythm strip shows asystole, a flatline with no electrical activity. The priority intervention is to initiate and continue high-quality cardiopulmonary resuscitation (CPR) immediately and continue until the code is terminated by the physician. This is consistent with Advanced Cardiac Life Support (ACLS) guidelines.
D. Administer adenosine 12 mg IV push: Adenosine is used to terminate supraventricular tachycardia (SVT) and is not indicated in asystole or during cardiac arrest. It would have no effect in a rhythm with no electrical activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Amiodarone: Amiodarone is a Class III antiarrhythmic that primarily works by blocking potassium channels, thereby prolonging repolarization and the action potential duration. It is used to manage various atrial and ventricular arrhythmias, including atrial fibrillation and ventricular tachycardia.
B. Digoxin: Digoxin is a cardiac glycoside that increases myocardial contractility and slows conduction through the AV node. It does not affect potassium channels directly but rather works by inhibiting the sodium-potassium ATPase pump.
C. Verapamil: Verapamil is a calcium channel blocker (Class IV antiarrhythmic) that slows conduction through the AV node and is used to treat supraventricular tachyarrhythmias and hypertension. It has no significant effect on potassium channels.
D. Carvedilol: Carvedilol is a non-selective beta-blocker with some alpha-blocking effects. It reduces heart rate and blood pressure but does not block potassium channels or have antiarrhythmic properties in that classification.
Correct Answer is D
Explanation
A. Blood pressure reading of 120/80: While a normal blood pressure is desirable, this value alone does not indicate improvement in fluid overload or pulmonary symptoms. It may remain normal even if respiratory status worsens or fails to improve.
B. Urine output 30 mL for one hour: Although urine output is an important measure of diuretic effectiveness, 30 mL/hr is the minimum acceptable rate, not necessarily a strong indicator of clinical improvement. More robust diuresis may be expected following IV furosemide.
C. Serum sodium level is 135 mEq/L (135–145): A normal sodium level reflects stable electrolyte status but does not directly indicate improvement in pulmonary congestion or dyspnea. Sodium may be affected by many factors unrelated to heart failure symptom relief.
D. Respiratory rate 16 per minute: A decrease in respiratory rate from 26 to 16 suggests improved oxygenation, reduced pulmonary congestion, and decreased work of breathing. It is the most direct and clinically relevant indicator of symptomatic improvement in this context.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today