A client with end stage renal disease presents to the emergency department with severe fatigue, palpitations, and muscle weakness.
The electrocardiogram reveals peaked T waves and a widened QRS complex. Which treatment should the nurse anticipate?

Administer a loop diuretic.

Administer furosemide.

Initiate hemodialysis.

Increase fluid intake.

Answer and Explanation

The Correct Answer is C

Managing electrolyte imbalances in end stage renal disease requires understanding renal excretion failures. The presence of cardiac rhythm changes indicates a life threatening emergency. Immediate intervention is necessary to remove toxins and excess ions that the kidneys cannot process.

Choice A rationale

Loop diuretics are ineffective for clients with end stage renal disease because the nephrons are no longer functional. These medications cannot induce diuresis or lower serum potassium levels when the kidneys have reached the point of failure.

Choice B rationale

Similar to other loop diuretics, furosemide relies on renal blood flow and functional kidney tissue to promote fluid and electrolyte excretion. In end stage failure, this medication will not resolve the cardiac symptoms or hyperkalemia.

Choice C rationale

This is the definitive treatment for life threatening hyperkalemia in renal failure. Dialysis rapidly removes excess potassium and metabolic waste from the blood. It corrects the electrical instability in the heart caused by the high potassium levels.

Choice D rationale

Increasing fluid intake is contraindicated in end stage renal disease due to the risk of fluid volume overload. This would exacerbate the client's condition, potentially leading to pulmonary edema, hypertension, and worsening of the cardiac strain.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

This scenario requires applying advanced cardiac life support protocols for post-arrest arrhythmias. Knowledge of autonomic nervous system pharmacology is essential to identify the specific medication that increases heart rate by blocking parasympathetic vagal inhibition on the sinoatrial node during symptomatic bradycardia.

Choice A rationale

Magnesium sulfate is primarily utilized to treat torsades de pointes or hypomagnesemia. It acts as a calcium channel blocker in myocardial cells but does not specifically increase heart rate for bradycardia when normal sinus rhythm has already been restored.

Choice B rationale

Sodium bicarbonate is administered to treat specific metabolic acidosis or certain drug toxicities during prolonged arrest. It does not possess chronotropic properties and will not increase the heart rate in a client suffering from a symptomatic slow rhythm.

Choice C rationale

Atropine is an anticholinergic drug that inhibits the vagus nerve, effectively increasing the firing rate of the sinoatrial node. It is the first-line medication for symptomatic bradycardia to improve cardiac output and maintain adequate systemic tissue perfusion.

Choice D rationale

Epinephrine is a potent vasopressor and inotrope used primarily during active pulseless arrest. While it increases heart rate, atropine is specifically indicated first for a restored rhythm that remains slow and symptomatic before progressing to more powerful infusions.

A. Different blood pressures in the upper limbs. B. Differences in upper and lower lung sounds. C. Different apical and radial pulses. D. Differences between oral and axillary temperatures.

Correct Answer is C

Explanation

Identifying cardiac arrhythmias requires understanding the relationship between electrical conduction and mechanical output. Knowledge of pulse deficits is necessary to recognize when rapid, irregular atrial contractions fail to produce adequate ventricular filling and a palpable peripheral pulse.

Choice A rationale

Blood pressure discrepancies between the upper limbs usually indicate vascular issues like aortic dissection or peripheral arterial disease. Atrial fibrillation affects the rhythm and volume of the pulse rather than creating localized pressure differences between the arms.

Choice B rationale

Variations in lung sounds typically suggest localized pulmonary pathology such as pneumonia or pleural effusion. While atrial fibrillation can lead to heart failure and pulmonary edema, it does not specifically cause differences between upper and lower sounds.

Choice C rationale

A pulse deficit occurs when the apical heart rate is higher than the radial rate. In atrial fibrillation, some ventricular contractions are too weak to perfuse to the periphery, making this a classic assessment finding.

Choice D rationale

Discrepancies between oral and axillary temperatures relate to thermoregulation and measurement accuracy rather than cardiac rhythm. Temperature monitoring is used to screen for infection or inflammation but does not provide diagnostic information regarding atrial arrhythmias..

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client with end stage renal disease presents to the emergency department with severe fatigue, palpitations, and muscle weakness. The electrocardiogram reveals peaked T waves and a widened QRS complex. Which treatment should the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client's restored rhythm is symptomatic bradycardia?

Correct Answer is C

Explanation

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation?

Correct Answer is C

Explanation

A client who had a stroke is admitted to the neurological floor in a rehabilitation hospital. Which interdisciplinary team member should the nurse consult to assist with the client's activities of daily living?

The nurse provides discharge teaching to a client who had a myocardial infarction. Which statements by the client indicate an understanding? Select all that apply.

A client in the rehabilitative phase of a burn injury has healed graft sites and is beginning mobility exercises. Which intervention is most important to minimize scarring and promote functional recovery?

The emergency department nurse assesses a client with a head injury. The client lost consciousness at the time of the head injury and then regained consciousness but is now unconscious again. Which condition does the nurse suspect?

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood?

The nurse assesses a terminally ill client who is nearing death. The client's wife expresses concern that he has no appetite and eats very little. How should the nurse best respond?

A client with end stage renal disease presents to the emergency department with severe fatigue, palpitations, and muscle weakness.
The electrocardiogram reveals peaked T waves and a widened QRS complex. Which treatment should the nurse anticipate?