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 C

Explanation

Choice A rationale
Moon facies, characterized by a round face, is a side effect of long-term use of prednisone. However, it is not the most important symptom for the client to report to the healthcare provider in this context.
Choice B rationale
Abdominal striae, or stretch marks on the abdomen, can also be a side effect of long-term use of prednisone. While it may be a concern for some patients due to cosmetic reasons, it is not the most critical symptom to report in this case.
Choice C rationale
Gastric irritation is a common side effect of prednisone and can lead to more serious complications such as gastric ulcers if not addressed promptly. Therefore, it is the most important symptom for the client to report to the healthcare provider.
Choice D rationale
Rapid weight gain can be a side effect of prednisone use. While it is important to monitor weight while on this medication, it is not the most critical symptom to report in comparison to gastric irritation.

A. Pallor B. Right-sided paralysis C. 2+ pitting edema of the feet D. Orthopnea .

Correct Answer is D

Explanation

Choice A rationale
While pallor can indicate various health issues such as anemia or low blood flow, it is not the most crucial finding when planning to provide a complete bed bath to a bedfast client.
Choice B rationale
Right-sided paralysis could affect the client’s ability to assist with the bath and could require special care or positioning. However, it is not the most crucial finding in this context.
Choice C rationale
2+ pitting edema of the feet could indicate fluid overload or poor circulation, but it is not the most crucial finding when planning to provide a complete bed bath.
Choice D rationale
This is the correct answer. Orthopnea, or difficulty breathing while lying flat, is the most crucial finding in this context. If a client has orthopnea, they may need to be positioned in a way that allows them to breathe comfortably during the bath.

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Naxlex Comprehensive Predictor Exams

A client with gout in the left great toe has received a prescription for prednisone 30 mg by mouth to be administered each day. Which symptom is most important for the client to report to the healthcare provider?

Correct Answer is C

Explanation

Which assessment finding is most crucial when planning to provide a complete bed bath to a bedfast client?

Correct Answer is D

Explanation

A client with deep vein thrombosis (DVT) in the left leg is on a heparin protocol. Which intervention is most important for the nurse to include in this client’s plan of care?

The nurse uses the Modified Caregiver Strain Index (MCSI) and determines that the daughter is under significant stress caused by the assumption of her mother’s care.

A patient with pancreatic cancer develops ascites, and 2 liters of fluid are removed via paracentesis. What schedule should the nurse follow to monitor the patient’s blood pressure after this procedure?

A client with chronic kidney disease (CKD) has elevated blood urea nitrogen (BUN) and serum creatinine levels. The client reports feeling fatigued and is unable to concentrate during the morning assessments. What action should the nurse take based on these findings?

A client with a venous ulcer, which has not responded to intravenous vancomycin treatment and is discharging pus, has been admitted with a potential infection of Vancomycin-Resistant Enterococci (VRE). Which nursing interventions should be included in the care plan? Select all that apply.

What action should the school nurse take to provide secondary prevention for school-aged children?

A client with a right hemopneumothorax has a chest tube connected to suction. While turning to the left side, the client becomes suddenly short of breath and anxious. What should the nurse do next?