A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

Synchronized electrical cardioversion

Cardiac resynchronization therapy (CRT)

Heart catheterization with percutaneous intervention

Echocardiogram

Answer and Explanation

The Correct Answer is B

A. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to restore normal sinus rhythm in patients with certain types of arrhythmias, such as atrial fibrillation or atrial flutter. However, it is not typically indicated for all patients with worsening heart failure and arrhythmias.

B. Cardiac resynchronization therapy (CRT): CRT, also known as biventricular pacing, involves the placement of a specialized pacemaker device to improve the coordination of contractions between the heart's chambers. It is often used in patients with heart failure and arrhythmias to help regulate the rhythm and improve cardiac function.

C. Heart catheterization with percutaneous intervention: Heart catheterization with percutaneous intervention, such as angioplasty or stent placement, is used to treat coronary artery disease by opening narrowed or blocked blood vessels. While coronary artery disease may contribute to heart failure, this procedure specifically targets the coronary arteries rather than arrhythmias.

D. Echocardiogram : An echocardiogram is a diagnostic test that uses sound waves to create images of the heart's structure and function. While an echocardiogram may provide valuable information about the heart's condition in a patient with heart failure and arrhythmias, it is not a procedure used to regulate the rhythm directly.

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Correct Answer is A

Explanation

A. Ask the client to move their eyes side to side while keeping their head still: This action helps assess if movement exacerbates the client's tinnitus. Tinnitus that worsens with eye movement suggests a potential vascular cause, as the blood vessels surrounding the auditory nerve may be affected. This maneuver is known as the Valsalva maneuver and can help identify vascular issues contributing to tinnitus.

B. Ask the client to breathe in through pursed lips: Breathing through pursed lips is a technique used to help manage shortness of breath and is not directly related to assessing tinnitus or its exacerbating factors.

C. Ask the client to pull the pinna of their ears up and back: Pulling the pinna of the ears up and back is a maneuver commonly performed during otoscopic examination to straighten the ear canal for better visualization of the tympanic membrane. It is not directly relevant to assessing tinnitus or its exacerbating factors.

D. Ask the client to open their mouth widely: Opening the mouth widely is not typically associated with exacerbating tinnitus. This action is more relevant for assessing temporomandibular joint (TMJ) dysfunction or other oral conditions but is not specific to tinnitus assessment.

A. Elevated erythrocyte sedimentation rate (ESR) B. Elevated thyroid-stimulating hormone (TSH) C. Elevated brain natriuretic peptide (BNP) D. Elevated C-reactive protein (CRP)

Correct Answer is B

Explanation

A. Elevated erythrocyte sedimentation rate (ESR): Elevated ESR indicates inflammation in the body and is not typically associated with the cause of atrial fibrillation.

B. Elevated thyroid-stimulating hormone (TSH): This is the correct answer. A common cause of atrial fibrillation is hyperthyroidism, which is characterized by an overactive thyroid gland and often presents with elevated TSH levels. Thyroid hormones play a significant role in regulating heart rate and rhythm. Excess thyroid hormone can lead to increased heart rate and irregular heart rhythms, including atrial fibrillation.

C. Elevated brain natriuretic peptide (BNP): Elevated BNP levels are associated with heart failure and may indicate cardiac stress or dysfunction. While heart failure can predispose individuals to atrial fibrillation, elevated BNP levels themselves are not a direct cause of atrial fibrillation.

D. Elevated C-reactive protein (CRP): Elevated CRP levels indicate inflammation in the body and are associated with various cardiovascular diseases. While inflammation can contribute to atrial fibrillation, elevated CRP levels alone are not a direct cause of atrial fibrillation.

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A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who reports manifestations of tinnitus. Which of the following actions should the nurse perform to determine if movement is causing the clients manifestations to worsen?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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