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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Correct Answer is A

Explanation

A. Stage 1 hypertension is classified as a systolic BP of 130-139 mm Hg or diastolic BP of 80-89 mm Hg. While the readings provided are close, the higher diastolic value of 88 mm Hg falls into the Stage 1 hypertension category.
B. The term prehypertension is outdated and replaced by elevated BP, which refers to systolic 120-129 mm Hg and diastolic <80 mm Hg. The client’s diastolic values are too high for this category.
C. A normal BP is <120/80 mm Hg, and the client’s readings exceed this range.
D. Stage 2 hypertension is ≥140/90 mm Hg, which does not apply to this client.

A. First-degree AV block B. Sinus tachycardia C. Atrial fibrillation D. Sinus bradycardia

Correct Answer is C

Explanation

A. First-degree AV block is characterized by a prolonged PR interval but does not typically present with irregular palpitations or a pulse deficit.
B. Sinus tachycardia causes a rapid but regular rhythm, whereas atrial fibrillation is irregularly irregular.
C. Atrial fibrillation is the correct answer. It is characterized by an irregular heart rate, absence of distinct P waves on an ECG, and a pulse deficit due to ineffective atrial contractions leading to incomplete ventricular filling.
D. Sinus bradycardia presents as a slow, regular heart rate rather than a rapid, irregular rhythm with a pulse deficit.

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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that their blood pressure readings of 124/84 mm Hg and 128/88 mm Hg place them in which of the following categories?

Correct Answer is A

Explanation

A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?

Correct Answer is C

Explanation

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?

Identify the following Cardiac Rhythm:

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?

A nurse is assessing a client two months after mitral valve replacement. The client complains of malaise, anorexia, weight loss, chills, and fever. The nurse suspects the client may have endocarditis. What other assessment sign is associated with infectious endocarditis?

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 reviewing the lab results and electrocardiogram (ECG) of a patient with End Stage Renal Disease (ESRD). The nurse correlates which ECG finding to a potassium level of 6.8?

A nurse is providing care and education to a client after an acute myocardial infarction. Which of the following statements should the nurse make regarding cardiac enzyme studies?

A nurse is caring for a client who is having an acute myocardial infarction (MI). The nurse is aware that which of the following are part of the assessment of cardiac pain? (SELECT ALL THAT APPLY).