A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?

Test the equipment by delivering a smaller shock at 50 J.

Administer 2 mg of intravenous epinephrine.

Make sure that the defibrillator is set to the synchronous mode.

Ensure that everyone is clear of contact with the client and the bed.

Answer and Explanation

The Correct Answer is D

A. Testing the equipment with a smaller shock is unnecessary when preparing to defibrillate in an emergency.

B. Epinephrine is used in cases of cardiac arrest with no pulse, particularly in asystole or pulseless electrical activity (PEA), not immediately before defibrillation in ventricular fibrillation.

C. Synchronous mode is used for cardioversion, not for defibrillation. Defibrillation should be delivered in unsynchronized mode.

D. Before delivering a shock, it is essential to ensure that everyone, including the nurse, is clear of the client and any conductive surfaces like the bed. This prevents injury from the electrical shock.

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Correct Answer is D

Explanation

A. Chronic asymptomatic HIV infection refers to a phase with no opportunistic infections and higher CD4+ counts.

B. A CD4+ T cell count below 200 cells/μL is abnormal and diagnostic of AIDS, not within the normal range.

C. The acute HIV infection phase occurs shortly after exposure, characterized by flu-like symptoms and high viral load, not opportunistic infections.

D. The presence of Pneumocystis jiroveci pneumonia (an AIDS-defining illness) and a CD4+ T cell count below 200 cells/μL confirms a diagnosis of AIDS.

A. Apply a paper bag over the clients nose and mouth. B. Administer 50 mL of 20% glucose and 20 units of regular insulin. C. Administer 50 mL of sodium bicarbonate intravenously. D. Apply oxygen by mask or nasal cannula.

Correct Answer is D

Explanation

A. Appling a paper bag over the client's nose and mouth is used for hyperventilation or respiratory alkalosis, not for respiratory acidosis. In this case, it would worsen the client’s condition by increasing CO2 retention.

B. Administering 50 mL of 20% glucose and 20 units of regular insulin is appropriate for hyperkalemia or diabetic ketoacidosis, not respiratory acidosis following a seizure.

C. Administering 50 mL of sodium bicarbonate intravenously is used for severe metabolic acidosis. This client’s acidosis is primarily respiratory in origin, making this choice inappropriate.

D. Applying oxygen by mask or nasal cannula helps correct the low oxygen levels and supports respiration post-seizure.

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A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A client has just experienced a 90-second tonic-clonic seizure and has the following arterial blood gas results: pH 7.12, HCO3 22 mEq/L, PaCO2 55 mmHg, PaO2 60 mmHg. Which intervention is the most appropriate?

Correct Answer is D

Explanation

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