A nursing student is looking at a telemetry screen with multiple rhythms. The unit is a step-down cardiac unit with delicate patients. Patients on Census. The unit has:

1. 84-year-old male with AFib, diaphoretic, and complaining of fatigue.

2. 45-year-old female with SVT not responding to adenosine.

3. 78-year-old female with bradycardia who was given atropine and epinephrine, yet unresolved.

4. 80-year-old male in pulseless Ventricular fibrillation being coded and transferred to Intensive Care Unit.

5. 69-year-old female who arrived at the unit symptomatic and currently being coded is pulseless with Ventricular Tachycardia.

The nurse on the step-down unit explains to the nursing student the electricity to be used for each dysrhythmia. Select the correct electricity to be used to manage the dysrhythmias listed:

Transcutaneous Pacing, Defibrillation, or Synchronized cardioversion?

Dysrhythmias:

1. Ventricular fibrillation.

2. PVC-run ventricular tachycardia with a pulse.

3. Atrial Flutter.

4. Bradycardia.

Ventricular fibrillation

PVC-run ventricular tachycardia with a pulse.

Atrial Flutter.

Bradycardia

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"C"},"D":{"answers":"A"}}

Ventricular fibrillation: The correct electricity is Defibrillation. Ventricular fibrillation is a life-threatening condition that requires immediate medical attention. Defibrillation is the process of delivering an electric shock to the heart to stop the fibrillation and allow the heart’s normal rhythm to resume4.

PVC-run ventricular tachycardia with a pulse: The correct electricity is Synchronized Cardioversion. This is used when the patient is hemodynamically stable. It involves the delivery of a therapeutic dose of electrical current to the heart at a specific moment in the cardiac cycle5.

Atrial Flutter: The correct electricity is Synchronized Cardioversion. Atrial flutter is a type of abnormal heart rhythm, or arrhythmia. It can be treated with synchronized cardioversion, in which a controlled electric shock is delivered to the heart to restore normal rhythm5.

Bradycardia: The correct electricity is Transcutaneous Pacing. This is a temporary means of pacing a patient’s heart during a medical emergency. It should be undertaken by healthcare providers who are trained in the procedure5.

So, the correct answer is Defibrillation for Ventricular fibrillation, Synchronized Cardioversion for PVC-run ventricular tachycardia with a pulse and Atrial Flutter, and Transcutaneous Pacing for Bradycardia, after analyzing all choices.

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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A rationale:
Vitamin K is not specifically related to the management of bipolar disorder or the use of lithium.
Choice B rationale:
Clients under lithium therapy don’t need to limit their sodium intake. It is recommended to keep salt intake the same as before prescription of the lithium medication.
Choice C rationale:
While potassium is an important dietary element, it is not specifically related to the management of bipolar disorder or the use of lithium.
Choice D rationale:
Vitamin C is not specifically related to the management of bipolar disorder or the use of lithium.

A. Twisting tongue movements. B. Shuffling gait. C. Sudden onset of high fever. D. Constant tapping of feet when sitting.

Correct Answer is A

Explanation

Choice A rationale:

Twisting tongue movements are a common symptom of tardive dyskinesia (TD), a side effect of long-term use of antipsychotic medications like fluphenazine.

Choice B rationale:

Shuffling gait is more commonly associated with Parkinson’s disease and certain antipsychotic medications can cause Parkinson-like symptoms, but it is not a characteristic of TD2.

Choice C rationale:

Sudden onset of high fever is not associated with TD. It could be a sign of a serious condition like neuroleptic malignant syndrome, which requires immediate medical attention.

Choice D rationale:

Constant tapping of feet when sitting could be a sign of restlessness or akathisia, another potential side effect of antipsychotic medications, but it is not a specific sign of TD2.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. The nurse should instruct the client to ensure an adequate intake of which of the following dietary elements?

Correct Answer is B

Explanation

A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?.

Correct Answer is A

Explanation

A nurse is talking with a client who has schizophrenia. Suddenly the client states, "I'm frightened. Do you hear that? The voices are telling me to do terrible things.”. Which of the following responses by the nurse is appropriate?.

A nurse in an acute mental health unit is admitting a client who has bipolar disorder. Which of the following findings supports the admitting diagnosis of acute mania?

A nurse asks a client who is suicidal to make a safety contract, but the client declines. Which of the following actions should the nurse identify as the priority?.

A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?

A nurse is assessing a client who is receiving treatment with multiple antipsychotic medications and who suddenly became ill. Findings include blood pressure changes, hyperpyrexia, and diaphoresis. The nurse should recognize that which of the following adverse effects may be occurring?

A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder.(Select all that apply.).

A nurse is reviewing laboratory results for a client and notes a serum lithium level of 1.6 mEq/L. Which of the following manifestations should the nurse expect the client to report?.

A nurse is preparing to teach a client about his prescription of lithium for the treatment of bipolar disorder. Which of the following statements should the nurse include in the teaching?