A client with atrial fibrillation is scheduled for an elective cardioversion.

The nurse prepares for the procedure by inserting two intravenous (IV) catheters and connecting the monitoring lead wires to the client.
Which action is most crucial for the nurse to take before initiating the cardioversion?

Activate the synchronization mode.

Choose a monitor lead with a tall R wave.

Administer the prescribed sedative.

Verify the prothrombin time (PT).

Answer and Explanation

The Correct Answer is C

Choice A rationale
Activating the synchronization mode is important during cardioversion to avoid delivering a shock during the vulnerable period of cardiac repolarization, which could potentially cause a life-threatening arrhythmia. However, it is not the most crucial action.
Choice B rationale
Choosing a monitor lead with a tall R wave can help ensure that the cardioverter-defibrillator can sense the patient’s intrinsic cardiac activity. However, this is not the most crucial action.
Choice C rationale
Administering the prescribed sedative is the most crucial action before initiating cardioversion. Sedation is necessary to ensure patient comfort and cooperation during the procedure, as cardioversion can be painful.
Choice D rationale

Verifying the prothrombin time (PT) is important in patients receiving anticoagulation therapy, as atrial fibrillation increases the risk of thrombus formation. However, it is not the most crucial action before initiating cardioversion.

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Correct Answer is A

Explanation

Choice A rationale
In a client with gastroenteritis experiencing fever, chills, anorexia, and diarrhea, fluid volume deficit is a major concern. Diarrhea and fever can both lead to significant fluid loss. If not addressed, fluid volume deficit can lead to serious complications such as hypovolemic shock.
Choice B rationale
While impaired bed mobility may be a concern due to the client’s history of stroke, it is not the highest priority in this situation. The immediate physiological needs related to the client’s gastroenteritis and potential fluid volume deficit should be addressed first.
Choice C rationale
Caregiver role strain may be a concern given that the client is dependent on care provided by the spouse. However, this psychosocial issue is not the highest priority when the client is experiencing acute physical symptoms that need immediate attention.
Choice D rationale
Bowel incontinence could be a concern for a client with gastroenteritis. However, the risk of fluid volume deficit due to diarrhea and fever is a more immediate concern.

A. Initiate two large-bore IV catheters and review the inclusion criteria for IV fibrinolytic therapy. B. Start continuous observation for transient episodes of neurologic dysfunction. C. Elevate the head of the bed to 30 degrees, keeping the head and neck in neutral alignment. D. Administer aspirin to prevent further clot formation and platelet aggregation.

Correct Answer is A

Explanation

Choice A rationale
If a patient suddenly experiences numbness and weakness on the right side of their body, including their arm and leg, and a distinct droop on the right side of the patient’s face, these are warning signs of a stroke. The nurse’s first course of action should be to initiate two large- bore IV catheters and review the inclusion criteria for IV fibrinolytic therapy. This is because rapid administration of fibrinolytic therapy can significantly improve outcomes in patients with acute ischemic stroke.
Choice B rationale
Continuous observation for transient episodes of neurologic dysfunction is important, but the immediate priority is to prepare for potential fibrinolytic therapy.
Choice C rationale
Elevating the head of the bed to 30 degrees and keeping the head and neck in neutral alignment can be beneficial in certain situations, but it is not the immediate priority in this scenario.

Choice D rationale
Administering aspirin can help prevent further clot formation and platelet aggregation in patients with acute coronary syndrome or those at high risk of cardiovascular disease.
However, in the case of a suspected stroke, immediate medical evaluation and potential fibrinolytic therapy are the priorities.

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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