The nurse is caring for a client who has been successfully resuscitated following a cardiac arrest and is now on an IV infusion of epinephrine. The cardiac monitor shows a heart rate of 120 beats/minute. What should be the nurse's best action?

Maintain the infusion because the client had a cardiac arrest.

Continue to monitor the client's rhythm closely.

Suggest that the client's medication be changed to norepinephrine.

Ask the physician if the dose can be decreased.

Answer and Explanation

The Correct Answer is D

A. Maintain the infusion because the client had a cardiac arrest: While epinephrine is essential during cardiac arrest, continuing a high-dose infusion post-resuscitation without reassessment may lead to complications like tachycardia, hypertension, and increased myocardial oxygen demand.

B. Continue to monitor the client's rhythm closely: Ongoing monitoring is important, but it is a passive intervention. The heart rate of 120 bpm may reflect excessive adrenergic stimulation from epinephrine, and further action is needed to prevent deterioration.

C. Suggest that the client's medication be changed to norepinephrine: Norepinephrine is another vasopressor that has less of a beta-1 adrenergic effect compared to epinephrine. It is primarily used for hypotension and septic shock, not as a direct substitute for epinephrine post-cardiac arrest. Changing to another vasopressor without indication is not the best initial step.

D. Ask the physician if the dose can be decreased: A heart rate of 120 bpm may indicate that the epinephrine dose is too high, causing sympathetic overstimulation. Prolonged or excessive tachycardia increases myocardial oxygen demand, which can be detrimental, especially in a post-arrest heart. Decreasing the dose can help prevent arrhythmias or myocardial ischemia, making this the most appropriate and proactive action.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is E

Explanation

A. contact the prescriber to decrease the rate of the D51/2NS during the blood transfusion: There's no need to alter the rate of maintenance fluids unless there's a fluid volume concern. Additionally, decreasing the rate would not address the need for a dedicated blood transfusion line if another lumen is available.

B. stop the D51/2NS, check the client's vitals & notify the prescriber: Stopping necessary fluids without cause may compromise fluid balance. Unless there's a compatibility issue or no other lumen, stopping the infusion is not the safest or most efficient action.

C. Fluids cannot be given through a CVC: Central venous catheters are routinely used for administering fluids, medications, and blood products, especially in critical care settings.

D. Insert a 22 gauge peripheral IV to administer the transfusion: While blood can be given through a peripheral IV, using an existing central venous catheter is safer and more efficient, especially when multiple lumens are available. Inserting a new IV unnecessarily increases infection and complication risks.

E. transfuse the unit of packed red blood cells through a separate lumen of the CVC: This is the safest and most appropriate action. Triple-lumen CVCs allow for simultaneous infusions through separate channels without mixing. Blood should be transfused through a dedicated lumen to avoid incompatibility or dilution by other fluids.

Correct Answer is ["0.5"]

Explanation

Convert milligrams to micrograms.

1 mg = 1000 mcg.

0.05 mg × 1000 mcg/mg = 50 mcg

Desired dose = 25 mcg

Available dose = 50 mcg/tablet

Calculate the number of tablets.

Number of tablets = Desired dose / Available dose per tablet

= 25 mcg / 50 mcg/tablet

= 0.5

The nurse should administer 0.5 tablet.

View Question and Answer

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

The nurse is caring for a client who has been successfully resuscitated following a cardiac arrest and is now on an IV infusion of epinephrine. The cardiac monitor shows a heart rate of 120 beats/minute. What should be the nurse's best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has a triple lumen subclavian central venous catheter (CVC) with D51/2NS infusing through one lumen (port) at 75 mL per hour. The nurse has an order to transfuse one unit of packed red blood cells (PRBCs). The nurse's safest action is to:

Correct Answer is E

Explanation

A client is to receive Synthroid 25 mcg PO daily. Synthroid unit dose available is 0.05 mg/ tablet. How many tablets (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)

Correct Answer is ["0.5"]

Explanation

A client in the coronary care unit is receiving a diltiazem infusion for atrial fibrillation. The nurse observes on the cardiac monitor that the client's heart rate has converted to sinus bradycardia at a rate of 50 beats/minute. Which nursing action should be performed first?

The nurse is caring for a client immediately following the insertion of a permanent pacemaker. Which intervention should be included in the plan of care?

The client hospitalized with infective endocarditis develops sharp flank pain and hematuria. The nurse notifies the physician, recognizing that these clinical manifestations may indicate:

Rhythm Strip The nurse is evaluating the following rhythm strip on a client in the telemetry unit. The client is alert and oriented but is complaining of slight nausea after eating breakfast. What is the nurse's best action?

Rhythm Strip A client comes to the emergency department (ED) complaining of a "racing heart and nervousness." The client's blood pressure is 106/60. The cardiac monitor displays the rhythm below. Which nursing action should be performed first?

The nurse observes the following rhythm of a client on the telemetry unit. Which action should be completed first?

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?

The nurse understands that chest pain related to pericarditis is classically relieved by