A nurse is caring for a client on a cardiac monitor. The patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern.

What is the first action the nurse should take?

Begin cardiopulmonary resuscitation (CPR).

Cardiovert the client with a biphasic defibrillator.

Assess airway, breathing, and circulation.

Administer an amiodarone bolus followed by a drip.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Beginning cardiopulmonary resuscitation (CPR) is not the first action a nurse should take when a patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern.
Choice B rationale
Cardioverting the client with a biphasic defibrillator is not the first action a nurse should take when a patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern.
Choice C rationale
The first action a nurse should take when a patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern is to assess the patient’s airway, breathing, and circulation.
Choice D rationale
Administering an amiodarone bolus followed by a drip is not the first action a nurse should take when a patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern.

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Correct Answer is C

Explanation

Choice A rationale
While obesity can contribute to hypertension and other cardiovascular diseases, it is not a contraindication for the use of propranolol. Weight management would be part of the overall treatment plan for hypertension, but it would not prevent the use of this medication.
Choice B rationale
Age is not a contraindication for the use of propranolol. While older adults may be more susceptible to certain side effects of the medication, age alone would not prevent a patient from taking propranolol.
Choice C rationale
Diabetes is a contraindication for the use of propranolol. Propranolol is a non-selective beta- blocker, which can mask symptoms of hypoglycemia, a common condition in people with diabetes. Therefore, it’s generally not recommended for people with diabetes.
Choice D rationale
Race is not a contraindication for the use of propranolol. While there are some differences in how people of different races may respond to certain medications, race alone would not prevent a patient from taking propranolol.

A. The patient should take the digoxin if their pulse is below 60 beats/min. B. The patient should notify the health care provider if they develop nausea. C. The patient should limit their dietary intake of potassium. D. The patient should take the hydrochlorothiazide at bedtime.

Correct Answer is B

Explanation

Choice A rationale
Digoxin slows the heart rate and increases the force of heart contractions, which can be beneficial in heart failure. However, if the pulse is below 60 beats/min, taking digoxin could further slow the heart rate and potentially lead to bradycardia.
Choice B rationale
Nausea can be a side effect of digoxin and hydrochlorothiazide. If the patient develops nausea, they should notify their healthcare provider as this could indicate that the medication dose needs adjustment.
Choice C rationale
Hydrochlorothiazide can cause the body to lose potassium, so limiting dietary intake of potassium could potentially lead to hypokalemia, a condition characterized by low potassium levels in the blood.
Choice D rationale
Taking hydrochlorothiazide at bedtime could potentially lead to nocturia, which is the need to wake up at night to urinate. This could disrupt the patient’s sleep.

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A nurse is caring for a client on a cardiac monitor. The patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. What is the first action the nurse should take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What factor would contraindicate the use of propranolol (Inderal) in a 38-year-old obese African American patient with diabetes who is being evaluated for hypertension control?

Correct Answer is C

Explanation

In the context of Interprofessional Care of the Client and Family Across the Lifespan, a nurse is planning discharge teaching for a patient with chronic heart failure who has been prescribed digoxin (Lanoxin) and hydrochlorothiazide. What instruction should the nurse include in the teaching?

Correct Answer is B

Explanation

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A nurse is caring for a client on a cardiac monitor. The patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern.

What is the first action the nurse should take?