A client comes to the emergency department with complaints of chest pain after using cocaine. The nurse assesses the client and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing?

Sinus bradycardia

Ventricular tachycardia

Normal sinus rhythm

Sinus tachycardia

Answer and Explanation

The Correct Answer is D

A. Sinus bradycardia is characterized by a heart rate below 60 beats/min, which is inconsistent with this client’s elevated heart rate of 128.
B. Ventricular tachycardia is a potentially life-threatening rhythm with wide QRS complexes, usually not the immediate expected rhythm without other signs such as hypotension or loss of consciousness.
C. Normal sinus rhythm has a heart rate between 60–100 beats/min; this client’s rate of 128 exceeds that range.
D. Sinus tachycardia is the most likely rhythm, especially in a client who has used cocaine, a stimulant known to increase sympathetic nervous system activity, leading to increased heart rate and elevated blood pressure.

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Correct Answer is B

Explanation

A. Spinal cord perfusion is not monitored with a pulmonary artery catheter; it typically requires different neuromonitoring techniques.
B. Hemodynamic status is accurately monitored using a pulmonary artery catheter (also called a Swan-Ganz catheter), which provides information on cardiac output, pulmonary artery pressures, and other cardiovascular parameters.
C. Intracranial pressure is monitored using devices like an intraventricular catheter or subarachnoid bolt, not a pulmonary artery catheter.
D. Renal function is assessed through laboratory tests (e.g., BUN, creatinine) and urine output, not via a pulmonary artery catheter

A. Stop and ventilate the patient with 100% oxygen. B. Give antidysrhythmic medications per protocol. C. Decrease the suction pressure to 80 mm Hg. D. Document the dysrhythmia in the patient's chart.

Correct Answer is A

Explanation

A. PVCs during suctioning may indicate hypoxia or irritation; the priority is to stop suctioning and ventilate the patient with 100% oxygen to prevent worsening arrhythmias.
B. Medications may be needed later, but immediate action is oxygenation and stopping suctioning.
C. Adjusting suction pressure is important but secondary to ensuring patient oxygenation.
D. Documentation is necessary but not the priority when PVCs are noted.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for transfer to the ICU for placement of a pulmonary artery catheter. The nurse should explain to the client that this catheter is used to monitor which of the following conditions?

Correct Answer is B

Explanation

The nurse notes premature ventricular contractions (PVCs) while suctioning a client's endotracheal tube. Which action by the nurse is a priority?

Correct Answer is A

Explanation

A nurse is preparing to administer warfarin to a client who has atrial fibrillation. The nurse should explain that the purpose of this medication is which of the following?

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