A client is admitted with uncontrolled atrial fibrillation with a rate between 120's-130's. IV heparin therapy is prescribed. In addition, the nurse prepares the client for a transesophageal echocardiogram (TEE). What does the nurse understand about this diagnostic study?

The TEE evaluates if emboli are present if cardioversion is required

The study will use electric current to stop the abnormal conduction pathway

A TEE will help restore the client's underlying baseline normal rhythm,

A TEE is required prior to implantable defibrillator placement in clients with atrial fibrillation

Answer and Explanation

The Correct Answer is A

A. The TEE evaluates if emboli are present if cardioversion is required: A transesophageal echocardiogram (TEE) provides detailed imaging of the heart’s chambers, particularly the left atrium and left atrial appendage, where clots often form in atrial fibrillation. It is used to rule out thrombi before cardioversion to reduce the risk of stroke during the procedure.

B. The study will use electric current to stop the abnormal conduction pathway: This describes electrical cardioversion, not TEE. TEE is a diagnostic imaging procedure and does not involve the delivery of electrical currents to modify the heart's rhythm or conduction.

C. A TEE will help restore the client's underlying baseline normal rhythm: TEE does not treat arrhythmias. Its role is diagnostic—to visualize cardiac structures, not to restore normal rhythm. Cardioversion or pharmacologic agents are required to correct atrial fibrillation.

D. A TEE is required prior to implantable defibrillator placement in clients with atrial fibrillation: TEE is not routinely required before implantable cardioverter-defibrillator (ICD) placement. ICD decisions are usually based on ejection fraction, rhythm stability, and risk of sudden cardiac arrest, not the presence or absence of atrial thrombi.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. calculate the number of small squares between one QRS complex and the next one and divide by 1500: This method provides an accurate heart rate calculation, but it is more time-consuming and typically used when precision is needed. It is not the quickest method for rapid bedside estimation of rate.

B. use the 3 second markers to count the number of QRS complexes in 6 seconds and multiply by 10: This is the fastest and most commonly used method for quickly estimating heart rate on an ECG strip. By counting the QRS complexes in a 6-second interval and multiplying by 10, the nurse gets an approximate beats-per-minute rate.

C. count the number of large squares in the R-R interval and divide by 300: This method also provides a quick estimate of heart rate but is best suited for regular rhythms. If the rhythm is irregular, this approach can yield inaccurate results.

D. print a 1-minute ECG strip and count the number of QRS complexes: While accurate, this method is inefficient for quick bedside estimation and is rarely used in practice for rapid assessment due to the time it takes to obtain and interpret a full-minute strip.

A. Administer amiodarone 200 mg IV push B. Defibrillate the client using 200 joules C. CPR until the physician stops the code D. Administer adenosine 12 mg IV push

Correct Answer is C

Explanation

A. Administer amiodarone 200 mg IV push: Amiodarone is used for shockable rhythms like ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) that are refractory to defibrillation. The rhythm on the monitor is asystole, which is non-shockable, and amiodarone is not indicated here.

B. Defibrillate the client using 200 joules: Defibrillation is only appropriate for shockable rhythms such as VF or pulseless VT. Asystole is not shockable, and defibrillation in this rhythm would be ineffective and inappropriate.

C. CPR until the physician stops the code: The rhythm strip shows asystole, a flatline with no electrical activity. The priority intervention is to initiate and continue high-quality cardiopulmonary resuscitation (CPR) immediately and continue until the code is terminated by the physician. This is consistent with Advanced Cardiac Life Support (ACLS) guidelines.

D. Administer adenosine 12 mg IV push: Adenosine is used to terminate supraventricular tachycardia (SVT) and is not indicated in asystole or during cardiac arrest. It would have no effect in a rhythm with no electrical activity.

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A client is admitted with uncontrolled atrial fibrillation with a rate between 120's-130's. IV heparin therapy is prescribed. In addition, the nurse prepares the client for a transesophageal echocardiogram (TEE). What does the nurse understand about this diagnostic study?

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is C

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