A nurse is caring for a client who reports shortness of breath and heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse palpates a rapid carotid pulse with a blood pressure of 70/30, and the client reports feeling dizzy. The nurse should anticipate the need for which priority action?

Initiate external pacing.

Initiate CPR.

Defibrillation.

Synchronized cardioversion.

Answer and Explanation

The Correct Answer is D

A. External pacing is not indicated for ventricular tachycardia with a pulse. Pacing is typically used for bradyarrhythmias.
B. CPR is only necessary if the client is pulseless. Since the client has a pulse, a more appropriate intervention is needed.
C. Defibrillation is used for pulseless VT or ventricular fibrillation, but this client has a pulse and is symptomatic.
D. Synchronized cardioversion is the appropriate intervention for unstable ventricular tachycardia with a pulse. The shock is synchronized to the R wave to prevent inducing ventricular fibrillation.

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Free Nursing Study Resources

Correct Answer is ["10"]

Explanation

Determine the heparin concentration:
- You have 25,000 units of heparin in 250 mL of normal saline.
- Concentration = 25,000 units / 250 mL = 100 units/mL
Calculate the mL/hr rate:
- The order is for 1,000 units/hour.
- Drip rate (mL/hr) = 1,000 units/hour / 100 units/mL = 10 mL/hour

Answer = 10mL/hr

A. Reduction of blood pressure to normal over a period of days B. Reduce the blood pressure to normal over a period of hours. C. Reduction of blood pressure by 50% in the first hour. D. Reduce blood pressure until the patient is asymptomatic.

Correct Answer is A

Explanation

A. In a hypertensive emergency, the goal is to reduce blood pressure gradually over 24 to 48 hours to prevent organ damage while avoiding excessive drops that could cause ischemia.
B. Rapid reduction of blood pressure over a few hours can lead to organ hypoperfusion and ischemic complications, such as stroke or acute kidney injury.
C. A 50% reduction in the first hour is too aggressive and may result in severe adverse effects such as cerebral or myocardial ischemia. The recommended initial reduction is no more than 25% in the first hour.
D. Treating hypertension based solely on symptoms is inappropriate, as some patients may be asymptomatic despite dangerously high blood pressure. The focus is on preventing target organ damage.

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Naxlex Comprehensive Predictor Exams

A Nurse is preparing to start a heparin drip on a client with acute coronary syndrome. Ordered: Give Heparin 1000 units per hour, standard dilution of 25,000 units in 250 mL of normal saline. What is the correct drip setting for the pump in mL/hr?

Correct Answer is ["10"]

Explanation

A nurse is caring for a client admitted with hypertensive emergency. The nurse is aware the treatment goals for the patient include which of the following?

Correct Answer is A

Explanation

A nurse is caring for a client in a critical care unit who is 4 hours post-operative coronary artery bypass surgery. The nurse performs the reassessment and suspects the client may be developing a pericardial effusion. What assessment findings would the nurse note in this case?

A nurse is caring for a client post-transcatheter aortic valve replacement (TAVR). During the first cardiac rehabilitation session, the client tells the nurse, "I do not need to be here. I am feeling so much better, I can do this at home." Which of the following is the appropriate nursing response?

A nurse is caring for a client with chest pain who becomes unresponsive. The client is pulseless and apneic. The code team places the client on the monitor, which indicates ventricular fibrillation. What is the next priority action?

A nurse is caring for a client post-cardiac catheterization with a right femoral artery puncture site. The nurse is aware that which of the following findings needs to be reported to the interventional cardiologist as soon as it is identified?

A nurse is caring for a client who is ordered Potassium 40 mEq IV. On hand is Potassium Chloride 20 mEq/mL. What is the nurse’s next action?

A nurse is caring for a client with a history of an abdominal aortic aneurysm (AAA). Which of the following assessments should be the nurse's priority for a client with an abdominal aortic aneurysm?

A nurse is caring for a client with heart failure (HF) and preparing to give a daily dose of Digoxin (Lanoxin). The nurse understands the rationale for giving this medication for HF is which of the following?