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 A
Explanation
A. Elevated troponins are the most specific and sensitive markers for myocardial injury. Troponin I and Troponin T levels rise within a few hours of an AMI and remain elevated for days, confirming cardiac damage.
B. Elevated hemoglobin is not an indicator of cardiac injury. Hemoglobin levels are used to assess oxygen-carrying capacity and anemia.
C. Elevated B-type natriuretic peptide (BNP) is a marker for heart failure, not acute myocardial infarction.
D. Elevated creatine kinase (CK), particularly CK-MB, can indicate muscle injury, including cardiac injury, but it is less specific than troponins for diagnosing AMI.
Correct Answer is C
Explanation
A. Nitroglycerin is used for angina and does not interact with contrast material or increase the risk of acute kidney injury.
B. Atorvastatin, a statin medication, is not known to interact with contrast dye or cause kidney injury in this context.
C. Metformin is contraindicated with contrast dye because it can increase the risk of lactic acidosis, especially in clients with impaired renal function. It should be withheld before and after the procedure to prevent complications.
D. Carvedilol, a beta-blocker, is used for blood pressure and heart failure management but does not interfere with contrast dye.
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