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

Perform a 12 lead EKG and request an order for bumetanide 0.5 mg IV

Administer pantoprazole sodium 40 mg by mouth to decrease GI distress

Administer carvedilol 10 mg by mouth and reassess in 30 minutes

Complete the remainder of the assessment and continue to monitor

Answer and Explanation

The Correct Answer is D

A.   The 12-lead EKG might be unnecessary right now, especially since the client has no other alarming symptoms. Bumetanide is also not indicated for nausea or tachycardia in this scenario.
B.   There is no clear indication that the nausea is related to acid reflux or GI distress that would justify pantoprazole.
C.   The tachycardia could be physiological, and treating it with a beta-blocker is unnecessary unless there is a more concerning underlying cause (like heart failure or ischemia). The priority here is not pharmacological intervention but monitoring the client's overall condition.
D.   This action allows for appropriate monitoring of the client's condition. Sinus tachycardia may resolve on its own without intervention, and the client doesn't exhibit severe symptoms requiring immediate pharmacologic treatment.

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Correct Answer is C

Explanation

A. Hypermagnesemia can cause bradycardia and hypotension, but it is less commonly associated with PVCs. This does not align with the lab results provided.
B. Hypocalcemia can cause arrhythmias, but it is not the most likely cause of PVCs in this case, considering other findings.
C. Hypokalemia (low potassium) is a known cause of PVCs. The patient's potassium level is 2.8 mEq/L, which is significantly low and most likely contributing to the PVCs.
D. Although hyperglycemia can affect cardiac function, it is less commonly linked to PVCs compared to electrolyte imbalances, such as hypokalemia.

A. Hemoglobin 10.1 g/di (normal Female: 11.7-15.5 g/dL: Male: 14-17.3 g/dL B. Brain natriuretic peptide 410 pg/mL (normal less than 100 pg/mL.) C. Sodium 132 mEq/L (normal 135 - 145 mEq/L) D. Fibrinogen level 201 mg/dL (normal 200-400 mg/dL)

Correct Answer is B

Explanation

A. A low hemoglobin level indicates anemia, not heart failure. While anemia can exacerbate heart failure, it is not the primary indicator.
B. BNP is a biomarker that is elevated in response to heart failure. A level above 100 pg/mL is suggestive of heart failure, and 410 pg/mL indicates significant heart stress and likely acute heart failure.
C. A low sodium level (hyponatremia) can occur in heart failure, but it is not specific enough to confirm the diagnosis. BNP is a more direct indicator of heart failure.
D. This is a normal fibrinogen level and does not indicate heart failure. Fibrinogen is more associated with clotting disorders.

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LAB	Result	Normal Range
Potassium	2.8 mEq/L	3.5-5.3mEq/L
Sodium	133 mEq/L	135-145 mEqL
Chloride	90 mEq/L	97-107 mEqL
Glucose	200 mg/dL	70mg/dL to 110mg/dL
Magnesium	2.5 mg/dL	1.6-2.2 mg/dL
Calcium	8.0 mg/dL	8.2-10.2 mg/dL:

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

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is caring for a client diagnosed with acute heart failure on the telemetry unit. Which laboratory result does the nurse know is most indicative of this diagnosis?

Correct Answer is B

Explanation

The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?

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