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?
Amiodarone administration
Defibrillation
Epinephrine administration
Synchronized Cardioversion
The Correct Answer is B
A. Amiodarone is an antiarrhythmic medication used after defibrillation and CPR in persistent ventricular fibrillation (VF) or ventricular tachycardia (VT). However, it is not the first priority.
B. Defibrillation is the immediate priority in a pulseless client with ventricular fibrillation. Early defibrillation increases the chances of survival. The shock should be delivered as soon as possible.
C. Epinephrine is given after the first defibrillation and CPR cycle, not before.
D. Synchronized cardioversion is inappropriate because it is used for unstable tachyarrhythmias with a pulse, not pulseless VF.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Muffled heart sounds are associated with pericardial effusion or tamponade, not infective endocarditis.
B. Palpitations can occur but are not a classic sign of infective endocarditis.
C. Hives suggest an allergic reaction, not endocarditis.
D. Splinter hemorrhages (tiny, red-brown streaks under the nails) are a classic sign of infective endocarditis due to small emboli from the infected heart valves.
Correct Answer is C
Explanation
A. Hypertensive crisis is not a direct complication of atrial fibrillation. It is typically caused by uncontrolled hypertension rather than arrhythmias.
B. Cardiogenic shock can occur in severe heart failure but is not a primary complication of atrial fibrillation.
C. Embolic cerebral vascular accident (stroke) is a major risk for clients with atrial fibrillation. The irregular atrial contractions allow blood to pool in the atria, increasing the risk of clot formation. If a clot dislodges, it can travel to the brain and cause a stroke.
D. Flash pulmonary edema is a complication of acute decompensated heart failure but is not directly caused by atrial fibrillation.
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