The nurse is caring for a recently admitted patient and notes the following priority intervention?
Administer Atropine 0.5 mg IVP
Start a Dobutamine infusion to stimulate heart function
Pace the patient at a rate of 72 beats per minute
Obtain vital signs and neurologic status
The Correct Answer is A
A. Atropine is the first-line medication for symptomatic bradycardia. It increases heart rate by blocking vagal stimulation. Timely administration prevents progression to hypotension, decreased cerebral perfusion, and cardiac arrest. This is the priority because it directly treats the life-threatening rhythm.
B. Dobutamine is a positive inotrope, used more for cardiogenic shock or reduced contractility. It is not first-line for bradycardia and does not address vagal-mediated slow HR. Only considered if atropine and pacing fail.
C. Transcutaneous pacing is appropriate if atropine is ineffective or if bradycardia is severe with instability. It is not the first step unless the patient is pulseless or profoundly unstable. Atropine should be tried first.
D. While assessment is important, the life-threatening rhythm must be stabilized immediately. Additional assessment delays treatment and risks deterioration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. In a COPD exacerbation, the primary concern is respiratory compromise. Monitoring respiratory rate, depth, pattern, and use of accessory muscles provides immediate information about the patient’s ventilatory status and oxygenation. Early recognition of worsening respiratory distress allows for prompt interventions such as supplemental oxygen, bronchodilators, or noninvasive ventilation.
B. While tachycardia may occur due to hypoxemia or stress, it is a secondary indicator and less directly reflective of acute respiratory status. Heart rate alone does not provide sufficient information about ventilation or gas exchange.
C. Fever may indicate infection, which can trigger or worsen an exacerbation, but it is not the most immediate indicator of respiratory compromise. Delaying attention to respiratory distress in favor of temperature assessment can lead to deterioration.
D. Blood pressure monitoring is important for overall hemodynamic status, but it does not directly assess the severity of a COPD exacerbation. It is a secondary consideration compared with respiratory assessment.
Correct Answer is B
Explanation
A. While involving the respiratory therapist is appropriate, obtaining a new ventilator does not immediately address the patient’s need for oxygenation and ventilation. Delaying manual ventilation could result in hypoxia or respiratory compromise.
B. When a high-pressure alarm sounds and the cause is unknown, the patient may not be receiving adequate ventilation. The priority is to ensure oxygenation and ventilation by manually ventilating with a bag-valve-mask (BVM). This stabilizes the patient while the nurse or respiratory therapist identifies and corrects the underlying issue, such as secretions, kinking of the tubing, or bronchospasm. This action follows the principle of airway, breathing, circulation (ABC) in critical care.
C. Although the patient may need further assessment, waiting for the rapid response team before providing immediate ventilation could delay critical intervention and compromise oxygenation. Rapid response may assist once the patient is stabilized.
D. Searching for the cause without first ensuring adequate ventilation risks patient hypoxia and deterioration. Identifying the problem is important, but patient stabilization takes priority over troubleshooting.
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