A client on a cardiac unit is experiencing atrial fibrillation with a rapid ventricular response of 140 beats per minute. The client is dizzy, short of breath, and hypotensive. Medications have not been effective at reducing the client's heart rate. Which procedure would the nurse anticipate to be performed for this client?

Defibrillation

Coronary artery stent placement

Echocardiogram

Synchronized cardioversion

Answer and Explanation

The Correct Answer is D

A.   Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia, where the heart is in a chaotic rhythm without an effective contraction.

B.   This procedure is performed to relieve significant blockages in coronary arteries that are causing myocardial ischemia or infarction. While coronary artery disease can contribute to cardiac issues, it is not the primary intervention for treating atrial fibrillation with a rapid ventricular response and associated symptoms like dizziness, shortness of breath, and hypotension.
C.   While an echocardiogram may be useful in assessing the overall cardiac function and structure, it is not an immediate intervention for the acute management of atrial fibrillation with a rapid ventricular response and unstable symptoms.
D.   Synchronized cardioversion is a procedure used to convert certain types of rapid arrhythmias, including atrial fibrillation, to a normal sinus rhythm by delivering a synchronized electrical shock to the heart at a specific point in the cardiac cycle.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B. While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C. ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D. Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.

Correct Answer is ["1.5"]

Explanation

To administer the correct dose of desipramine, which is 150 mg, when the available tablet strength is 100 mg, the nurse would need to give 1.5 tablets.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

Correct Answer is D

Explanation

Correct Answer is ["1.5"]

Explanation

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