The nurse is caring for a client with a spinal cord injury at C3. The nurse notices on the cardiac monitor a heart rate of 30 beats per minute & upon assessment of the patient, a change in mental status. What medication does the nurse anticipate will be ordered by the physician STAT?

Atropine 1mg IV push

Epinephrine 1 mg (1:10,000) IV X1

Adenosine 6 mg IV push

Milrinone 50 mcg/kg IV push

Answer and Explanation

The Correct Answer is A

A. Atropine 1 mg IV push

A C3 spinal cord injury disrupts sympathetic control, causing bradycardia. Atropine is the first-line treatment for symptomatic bradycardia.

B. Epinephrine 1 mg IV

Epinephrine is used for cardiac arrest, not initial management of bradycardia.

C. Adenosine 6 mg IV push

Adenosine is used for supraventricular tachycardia, not bradycardia.

D. Milrinone 50 mcg/kg IV push

Milrinone is an inotrope used in heart failure, not bradycardia.

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Correct Answer is D

Explanation

A. Prepare for immediate abdominal surgery
There is no indication of active hemorrhage or peritonitis at this point. Further assessment is needed before deciding on surgery.

B. Determine if there are any allergies to food or drugs
Allergy history is important, but it is not the immediate priority for this client.

C. Administer antibiotics as ordered after culture results are available
Antibiotics may be needed if infection is suspected, but the priority is assessing kidney function due to the risk of rhabdomyolysis from muscle breakdown.

D. Obtain a urine specimen
Flank pain after a crush injury suggests possible rhabdomyolysis or kidney damage. The urine should be tested for myoglobinuria (tea-colored urine), hematuria, or kidney injury markers.

A. Follows an object with eyes without nystagmus or strabismus B. Moves the tongue out midline without tremors or deviation C. Moves the head and shoulders against resistance with equal strength D. Demonstrates full range of the neck

Correct Answer is C

Explanation

A. Follows an object with eyes without nystagmus or strabismus
Cranial nerves III (oculomotor), IV (trochlear), and VI (abducens) control eye movement. CN XI does not control eye movement.

B. Moves the tongue out midline without tremors or deviation
Cranial nerve XII (hypoglossal nerve) controls tongue movement.

C. Moves the head and shoulders against resistance with equal strength
Cranial nerve XI (spinal accessory nerve) controls the sternocleidomastoid and trapezius muscles. If intact, the client can shrug shoulders and turn the head against resistance with equal strength.

D. Demonstrates full range of the neck
Full range of motion in the neck involves multiple muscles, not just those innervated by CN XI.

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The nurse is caring for a client with a spinal cord injury at C3. The nurse notices on the cardiac monitor a heart rate of 30 beats per minute & upon assessment of the patient, a change in mental status. What medication does the nurse anticipate will be ordered by the physician STAT?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is testing the function of cranial nerve XI (Spinal accessory nerve). Which finding would the nurse expect if the nerve is intact?

Correct Answer is C

Explanation

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