The nurse is providing discharge instructions to a client who has had a permanent pacemaker inserted. The information in the chart indicates that the device is a DDD. What will the nurse explain about this pacemaker?

"A wire is in the left ventricle and will pace when needed."

"There are pacemaker wires in the right atrium and ventricle and will pace as needed."

"The wires are in both ventricles and fires when your heart rate is 50.

"The device is set to fire with each heart beat."

Answer and Explanation

The Correct Answer is B

A.   The pacemaker wire for a DDD device is placed in the right atrium and right ventricle, not the left ventricle.
B.   This is the correct description of a DDD pacemaker, which has wires in both the right atrium and right ventricle to monitor and pace both chambers when needed.
C.   This is incorrect because a DDD pacemaker does not pace both ventricles.
D.   This is inaccurate because a DDD pacemaker does not fire with every heartbeat; it only fires when the heart’s natural electrical activity is insufficient.

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Correct Answer is A

Explanation

A. INR = 3.7: The International Normalized Ratio (INR) is a measure of blood clotting. An INR greater than
3.0 indicates that the blood is not clotting properly, which can be caused by warfarin overdose. An elevated INR requires FFP to correct coagulopathy.
B. Hemoglobin = 6.3g/dL: This is low, indicating anemia, but it is not directly related to warfarin overdose. The primary issue here is coagulopathy, not anemia.
C. Fibrinogen = 90mg/dL: Fibrinogen levels may be decreased in various conditions, but this alone does not necessarily require additional FFP unless it’s below a critical threshold. Fibrinogen is not the main marker for warfarin overdose.
D. Platelets = 101,000 mm3: This platelet count is within the lower end of the normal range but does not indicate that more FFP is needed in response to warfarin overdose.

A. “I probably will not have any transfusion reactions from my own blood." B. “This is the blood I've been giving for the past 6 weeks for myself. C. "I understand there is still a risk I can get hepatitis from this blood." D. "Since I have O negative blood, it's a good thing I'm getting my own blood."

Correct Answer is C

Explanation

A. “I probably will not have any transfusion reactions from my own blood.” - Autologous transfusions
generally have a lower risk of transfusion reactions because they involve the client’s own blood.
B. “This is the blood I’ve been giving for the past 6 weeks for myself.” - This is a correct understanding of the process of autologous blood donation, where the client donates blood for their own use.
C. An autologous blood transfusion involves the collection and storage of a patient's own blood for later transfusion. This significantly reduces the risk of bloodborne infections, such as hepatitis, HIV, and other blood-borne diseases, as the blood is coming from the patient themselves.
D. “Since I have O negative blood, it’s a good thing I’m getting my own blood.” - The client may not need additional teaching here because O negative blood is universally compatible, but the reason they are getting their own blood is due to the autologous donation process, not because of blood type.

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The nurse is providing discharge instructions to a client who has had a permanent pacemaker inserted. The information in the chart indicates that the device is a DDD. What will the nurse explain about this pacemaker?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who received a transfusion of Fresh Frozen Plasma (FFP) for an acute GI bleed related to accidental wantarin overdose. Which laboratory result would indicate the need for an additional unit of Fresh Frozen Plasma (FFP) to correct the problem caused by the overdose?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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