The nurse is caring for a client with acute heart failure who is severely dyspneic and extremely anxious. The nurse anticipates that increased cardiac output and decreased anxiety may be promoted by the IV administration of:

diltiazem.

nitroglycerine.

verapamil.

morphine.

Answer and Explanation

The Correct Answer is D

A.   Diltiazem is a calcium channel blocker that can be used to manage conditions like atrial fibrillation or hypertension by slowing the heart rate and reducing blood pressure. However, it may not be the most appropriate drug in the acute setting for heart failure with dyspnea.
B.   Nitroglycerine is a vasodilator that helps reduce preload and afterload, which can be beneficial in heart failure. However, it primarily works by reducing the workload on the heart and may help with fluid overload but may not directly address anxiety.
C.   Verapamil is another calcium channel blocker that slows the heart rate and reduces the heart's workload. While it may be useful for controlling tachyarrhythmias, it is not the best option for managing acute heart failure with severe dyspnea and anxiety.
D.   Morphine is an opioid that can be used in acute heart failure to reduce both anxiety and respiratory distress. It works by reducing the sympathetic nervous system response, decreasing heart rate and blood pressure, and providing a sense of calm, which reduces anxiety. It also reduces preload by venodilation and helps manage severe dyspnea.

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Correct Answer is A

Explanation

A. This statement indicates a need for further education. After receiving an ICD, clients must refrain from engaging in vigorous physical activities such as contact sports (e.g., football) for a longer period of time to avoid injury or triggering the defibrillator. A longer recovery period is typically recommended.
B. This is correct. Microwaves do not affect the function of an ICD, so it is safe to use one.
C. This is correct. The client should keep their cellphone at least 6 inches away from the ICD to avoid interference with the device.
D. This is correct. Clients may experience a sudden, forceful sensation similar to a kick or blow when the ICD delivers a shock to correct an arrhythmia.

A. count the number of large squares in the R-R interval and divide by 30C B. print a 1-minute ECG strip and count the number of ORS complexes, C. count the number of QRS complexes in 6 seconds and multiply by 10. D. calculate the number of small squares between one QRS complex and the next one and divide by 1500.

Correct Answer is C

Explanation

A. Counting the number of large squares between R-R intervals and dividing by 30 is not the correct method for estimating the ventricular rate on an ECG strip.
B. Printing a 1-minute ECG strip and counting the QRS complexes (option B) is accurate but unnecessary for a quick estimation.
C. The most common and efficient method for estimating the ventricular rate quickly is to count the number of QRS complexes in a 6-second strip (often marked by two dashed lines) and multiply by 10. This gives an estimate of the heart rate per minute.
D. Counting the number of small squares between QRS complexes and dividing by 1500 is the most accurate method but requires more time and precision than counting QRS complexes in 6 seconds.

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The nurse is caring for a client with acute heart failure who is severely dyspneic and extremely anxious. The nurse anticipates that increased cardiac output and decreased anxiety may be promoted by the IV administration of:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has provided teaching to a client who had an implantable cardioverter/defibrillator inserted. Which statement by the client indicates the need for further instruction?

Correct Answer is A

Explanation

When using an ECG rhythm strip to quickly estimate the ventricular rate for a client, the nurse should:

Correct Answer is C

Explanation

The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV. Which parameter would the nurse use to best evaluate if the client is responding to this medication?

The client diagnosed with acute heart failure is prescribed an infusion of dopamine at a low dose. Which assessment parameter should the nurse use to best evaluate the effectiveness of this medication?

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