A nurse on the cardiac care unit is caring for a client who is hemodynamically unstable. For which of the following dysrhythmias should the nurse plan for synchronized cardioversion?
Premature atrial complexes
Ventricular fibrillation
Atrial fibrillation
Ventricular asystole
The Correct Answer is C
Choice A reason: Premature atrial complexes are usually benign and do not require cardioversion. They are often managed with observation or medication if symptomatic.
Choice B reason: Ventricular fibrillation requires immediate defibrillation, not synchronized cardioversion, because there is no organized rhythm to synchronize with.
Choice C reason: Atrial fibrillation in a hemodynamically unstable client is correct. Synchronized cardioversion delivers a shock timed with the R wave to restore sinus rhythm and prevent deterioration.
Choice D reason: Ventricular asystole is a flatline rhythm and requires CPR and epinephrine, not cardioversion. Shocking asystole is ineffective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: "SQ q AM and q HS" is incorrect because it specifies morning and bedtime administration rather than every 12 hours. This could lead to dosing errors.
Choice B reason: "Enoxaparin 30 mg subcut every 12 hr" is the correct documentation. It uses standard terminology, specifies the correct dose, route, and frequency, and avoids abbreviations that could be misinterpreted.
Choice C reason: "30 mcg" is incorrect because it changes the dosage from milligrams to micrograms, which is a thousand-fold difference. This would result in a dangerous underdose.
Choice D reason: "sub q every AM and HS" is incorrect because it specifies administration twice daily at morning and bedtime rather than strictly every 12 hours. This could cause uneven dosing intervals.
Correct Answer is ["A","B","E"]
Explanation
Choice A reason: Absence of urine ketones is expected in hyperglycemic hyperosmolar state (HHS). Unlike diabetic ketoacidosis (DKA), HHS does not involve significant ketone production because insulin levels are usually sufficient to prevent lipolysis and ketogenesis.
Choice B reason: Blood glucose levels in HHS are extremely elevated, often exceeding 600 mg/dL. A value of 685 mg/dL is consistent with this condition and reflects the severe hyperglycemia that drives osmotic diuresis and dehydration.
Choice C reason: A BUN of 8 mg/dL is within normal range and would not be expected in HHS. Typically, BUN is elevated due to dehydration and reduced renal perfusion. Therefore, this finding is not consistent with HHS.
Choice D reason: Fruity breath odor is characteristic of diabetic ketoacidosis due to acetone accumulation from ketone metabolism. It is not expected in HHS, which lacks significant ketosis.
Choice E reason: Dehydration is a hallmark of HHS. Severe hyperglycemia causes osmotic diuresis, leading to profound fluid loss, hemoconcentration, and electrolyte imbalance.
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