The patient is complaining of nausea and shortness of breath. He is pale and diaphoretic. His heart rate is 62 bpm, but his rate is usually 86 bpm. His blood pressure is 82/56 mm Hg. His carotid and radial pulses are palpable. The patient's symptoms indicate a need for:
Epinephrine
Atropine
Adenosine
Amiodarone
The Correct Answer is B
A. Epinephrine: Epinephrine is primarily used in cardiac arrest or severe anaphylaxis to stimulate the heart and increase perfusion. While it increases heart rate and blood pressure, it is not the first-line treatment for symptomatic bradycardia in a patient who is still perfusing and has a palpable pulse.
B. Atropine: The patient is presenting with symptomatic bradycardia (heart rate 62 bpm, hypotension, pallor, diaphoresis, and shortness of breath). Atropine is the first-line therapy because it blocks vagal stimulation, increases sinoatrial node firing, and enhances AV conduction. It rapidly improves heart rate and perfusion in symptomatic bradycardia.
C. Adenosine: Adenosine is used to terminate supraventricular tachycardia by transiently blocking AV nodal conduction. It is contraindicated in bradycardia and would worsen the patient’s hypotension and symptoms, making it inappropriate.
D. Amiodarone: Amiodarone is used for ventricular arrhythmias or refractory tachyarrhythmias. It does not address bradycardia and could potentially exacerbate the slow heart rate, so it is not indicated for this patient’s presentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
A. Rapid saline flush following administration: Adenosine has an extremely short half-life (less than 10 seconds), so a rapid saline flush immediately after the IV push is essential to ensure the medication reaches the heart quickly. This enhances its effectiveness in terminating SVT by transiently blocking AV nodal conduction.
B. Rapid IV push administration: Adenosine must be administered as a rapid IV bolus, ideally through a proximal vein, to achieve immediate therapeutic effect. Slow administration can reduce its efficacy because the drug is metabolized almost immediately by the vascular endothelium and lungs.
C. Initial recommended dosage of 12 mg IV bolus: The initial recommended dose for adenosine is typically 6 mg IV push, not 12 mg. The dose may be increased to 12 mg if the first dose is ineffective. Administering 12 mg initially is higher than standard protocol and could increase the risk of transient adverse effects.
D. Long half-life of adenosine, which may prolong adverse medication effects: Adenosine actually has a very short half-life (less than 10 seconds), so adverse effects are brief and self-limiting. It does not have a prolonged effect, making this statement inaccurate.
E. Constant EKG monitoring: Continuous ECG monitoring is critical during adenosine administration because transient asystole or AV block may occur. Monitoring allows the nurse to immediately identify arrhythmia termination or adverse effects, ensuring patient safety throughout the intervention.
Correct Answer is C
Explanation
Rhythm: Sinus, regular
Rate: 120 b/min
P wave: Present, normal
PR interval: Normal, 0.16 seconds
QRS: Narrow, 0.04 seconds
Rhythm interpretation: Sinus tachycardia
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