Which antidysrhythmic would the nurse expect a 3 to 6 second run of asystole to follow?
Lidocaine
Adenosine
Atropine
Epinephrine
Amiodarone
The Correct Answer is B
A. Lidocaine: Lidocaine is a class IB antiarrhythmic used primarily for ventricular arrhythmias. While it can cause minor changes in conduction or suppress ectopic foci, it is unlikely to cause brief runs of asystole. Its mechanism stabilizes the ventricular myocardium rather than inducing transient pauses.
B. Adenosine: Adenosine is a rapid-acting antiarrhythmic used to terminate supraventricular tachycardia by transiently blocking AV nodal conduction. Its administration often causes a brief period of asystole or AV block lasting 3–6 seconds, which is expected and usually self-limiting. Patients may feel lightheaded or transiently unresponsive during this pause.
C. Atropine: Atropine is an anticholinergic agent used to treat symptomatic bradycardia by increasing heart rate through vagal inhibition. It does not cause asystolic episodes; rather, it accelerates sinus node firing, making it an unlikely cause of transient asystole.
D. Epinephrine: Epinephrine is a sympathomimetic that increases heart rate, contractility, and conduction. It is used in cardiac arrest and severe bradycardia, but it does not typically produce short runs of asystole; its effect is stimulatory, not suppressive, on cardiac conduction.
E. Amiodarone: Amiodarone is a broad-spectrum antiarrhythmic that slows conduction and prolongs repolarization. While it can cause bradycardia or AV block in some cases, brief runs of asystole lasting 3–6 seconds are not a common or expected effect of this drug.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Initiate CPR: Pulseless ventricular tachycardia is a life-threatening cardiac arrest rhythm. Immediate initiation of high-quality cardiopulmonary resuscitation (CPR) is the highest priority to maintain circulation and perfusion to vital organs. Early CPR improves the likelihood of return of spontaneous circulation and survival until defibrillation and advanced interventions can be performed.
B. Administer oxygen: While oxygen is important, providing supplemental oxygen does not replace the need for immediate CPR in a pulseless patient. Oxygen delivery becomes effective only if circulation is maintained, which is why CPR takes precedence.
C. Administer an antidysrhythmic agent: Antidysrhythmic drugs such as amiodarone may be used during pulseless V-Tach according to ACLS protocols, but administration is secondary to initiating CPR and defibrillation. Delaying CPR to give medication would reduce chances of survival.
D. Instruct the client to inhale deeply and cough: Cough CPR or the Valsalva maneuver is ineffective in true cardiac arrest. A pulseless, unconscious patient cannot follow commands, and these interventions do not provide circulation or address the life-threatening arrhythmia.
Correct Answer is C
Explanation
A. Nitroglycerine and Viagra should be taken at the same time: Taking nitroglycerine and Viagra together is extremely dangerous. Both drugs cause vasodilation and can lead to severe hypotension, syncope, or even cardiovascular collapse. Patients must be explicitly warned against simultaneous use.
B. Viagra is not effective when used in combination with nitroglycerine: The issue is not the efficacy of Viagra but the risk of life-threatening hypotension when the two medications are combined. Effectiveness of Viagra is not the concern; safety is the priority.
C. Viagra should not be used within 24 hours of taking nitroglycerine: The safest practice is to avoid nitrates for at least 24 hours after taking sildenafil (Viagra) due to the risk of profound hypotension. This instruction directly addresses patient safety and is a critical point for discharge teaching to prevent potentially fatal interactions.
D. The effect of nitroglycerine is impaired by concurrent use of Viagra: Nitroglycerine’s effectiveness is not impaired; instead, the combination potentiates vasodilation, leading to dangerously low blood pressure. The concern is additive hypotensive effects, not reduced efficacy of nitroglycerine.
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