A client with a permanent pacemaker has no pulse or spontaneous respirations and the monitor is displaying a ventricular fibrillation rhythm. Resuscitation is in progress and the nurse is preparing to defibrillate the client with 200 joules of unsynchronized defibrillation. Which intervention is most important for the nurse to implement?

Obtain 12-lead electrocardiogram to evaluate return of pacemaker's sensing, firing, and capture.

Ensure permanent pacemaker interrogated if return of spontaneous circulation is achieved.

Place self-adhesive defibrillator pads at least 1 inch away from permanent pacemaker site.

Apply a doughnut magnet over the pacemaker if pacer-mediated tachycardia develops.

Answer and Explanation

The Correct Answer is C

A. Obtaining a 12-lead ECG is done after return of spontaneous circulation (ROSC), not during defibrillation.
B. Interrogating the pacemaker is important but is not the immediate priority during resuscitation.
C. Defibrillator pads should be placed at least 1 inch away from the pacemaker to prevent damage to the device and ensure effective defibrillation.
D. A doughnut magnet is used to deactivate pacemaker functions in cases like pacemaker-mediated tachycardia but is not relevant in ventricular fibrillation.

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Correct Answer is D

Explanation

A: An indwelling urinary catheter is unnecessary for monitoring unstable angina and would not address the client’s immediate cardiac concerns.

B: Although evaluating perfusion is important, administering aspirin is a higher priority to prevent further damage from potential myocardial ischemia.

C: Obtaining consent for coronary angiography and percutaneous coronary intervention is important but should follow the administration of aspirin and other emergency interventions.

D: Aspirin is commonly given in suspected ACS to reduce platelet aggregation and prevent further clot formation. Chewing the aspirin improves its absorption and effectiveness in managing the acute event.

A. Determine how the client is administering the medication. B. Advise the client to gargle with warm salt water twice daily. C. Report the client's jaw pain to the healthcare provider. D. Confirm that this is a common symptom of osteoporosis.

Correct Answer is C

Explanation

A. Determine how the client is administering the medication: While the nurse should assess medication administration, jaw pain could be a sign of a serious side effect, and reporting to the healthcare provider is the priority.
B. Advise the client to gargle with warm salt water twice daily: Gargling with salt water may provide some comfort but is not an appropriate solution for jaw pain related to bisphosphonate therapy.
C. Report the client's jaw pain to the healthcare provider: Jaw pain could be a sign of osteonecrosis of the jaw, a rare but serious side effect of bisphosphonates. Immediate reporting is essential.
D. Confirm that this is a common symptom of osteoporosis: Jaw pain is not a common symptom of osteoporosis and should be assessed further.

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Naxlex Comprehensive Predictor Exams

A client with a history of unstable angina presents to the emergency department with constant chest pressure that is unrelieved with rest. The client appears anxious, pale, and diaphoretic. After obtaining the client's vital signs, which action should the nurse take next?

Correct Answer is D

Explanation

A female client is taking alendronate, a bisphosphonate, for postmenopausal osteoporosis. The client tells the nurse that she is experiencing jaw pain. How should the nurse respond?

Correct Answer is C

Explanation

Patient Data Exhibits Review H and P, nurse's notes, laboratory results, flow sheet, and prescriptions. Select the 3 findings that would require immediate action from the nurse while the laboring mother is receiving an epidural anesthesia.

Following a cardiac catheterization and placement of a stent in the right coronary artery, the nurse administers prasugrel to the client. To monitor for adverse effects from the medication, which assessment is most important for the nurse to include in this clients plan of care?

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

The nurse is providing education to a client who receives a prescription for zolpidem. Which information about the medication should the nurse include?

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

The friend of a nurse who works in an acute care hospital asks the nurse to review the adult daughter's electronic medical record (EMR) to determine if she is honestly disclosing her medical condition. The nurse's reply should include which information? Select all that apply.

The nursing staff on a medical unit includes a registered nurse (RN), practical nurse (PN), and an unlicensed assistive personnel (UAP). Which task should the charge nurse assign to the RN?