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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Correct Answer is C

Explanation

Choice A rationale:
Ensuring the client goes to group activities as planned is important, but not the priority when the client is confused and has distorted thinking.
Choice B rationale:
Using distraction such as television or music can be helpful, but it is not the priority intervention.
Choice C rationale:
Providing reassurance and comfort ensuring the client is safe is the priority as it directly addresses the client’s immediate needs.
Choice D rationale:
Giving PRN medications to treat increased hallucinations may be necessary, but it is not the first action to take.

A. Sexual dysfunction. B. Muscle spasms of the neck. C. Tremors of the hands. D. Fidgeting behavior. E. Blurred vision.

Correct Answer is ["B","C","D"]

Explanation

Choice A rationale:
Sexual dysfunction is not typically associated with extrapyramidal side effects (EPS). EPS are usually characterized by involuntary motor symptoms.
Choice B rationale:
Muscle spasms of the neck, also known as dystonia, are a common symptom of EPS12.
Choice C rationale:
Tremors of the hands can be a sign of EPS, often associated with drug-induced parkinsonism.
Choice D rationale:
Fidgeting behavior, or akathisia, is a common symptom of EPS. It is characterized by a feeling of restlessness and an inability to sit still.
Choice E rationale:
Blurred vision is not typically associated with EPS. It is more likely to be a side effect of the medication itself, not a symptom of EPS12.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been diagnosed with schizophrenia and appears confused and has distortions in their thinking and speech patterns. Which of the following is the priority nursing intervention for this client?

Correct Answer is C

Explanation

A nurse is assessing for the presence of extrapyramidal side effects (EPS) in a client who is taking chlorpromazine. Which of the following findings should the nurse recognize as EPS? (Select all that apply.).

Correct Answer is ["B","C","D"]

Explanation

A nurse in a mental health clinic is conducting a staff education session on schizophrenia. Which of the following manifestations should the nurse identify as negative symptoms? (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 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?

Which nursing intervention will have the greatest impact on both the management of care and on milieu environment when considering the clients diagnosed with bipolar disorder?

A nurse is caring for a client who has schizophrenia and is experiencing a variety of hallucinations. Which of the following hallucinations is the priority for the nurse to address?

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?.