A patient is admitted to the emergency department with clinical indications of an ST elevated myocardial infarction. The facility does not have the capability for percutaneous coronary intervention. Given this scenario, what is the priority intervention in the treatment and nursing management of this patient?

Administer thrombolytic therapy unless contraindicated

Keep oxygen saturation levels to at least 88%

Maintain heart rate above 100 beats/min

Administer diuretics aggressively and monitor daily weight

Answer and Explanation

The Correct Answer is A

A. Thrombolytic therapy is the priority in managing an ST-elevated myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. It helps dissolve the blood clot causing the blockage in the coronary artery.

B. Maintaining oxygen saturation is important, but the priority is to restore coronary blood flow.

C. The focus should be on stabilizing the heart rhythm, not specifically maintaining a high heart rate.

D. Diuretics are important in managing heart failure but are not the priority in acute STEMI management.

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Correct Answer is B

Explanation

A. Epinephrine is an important drug in resuscitation but is administered after defibrillation in the algorithm.

B. Defibrillation is the priority intervention for ventricular fibrillation, as it is the only treatment that can convert the heart rhythm back to a viable one.

C. Airway management is crucial, but in the context of ventricular fibrillation, defibrillation takes precedence to restore a life-sustaining rhythm.

D. Amiodarone is used in the treatment of refractory ventricular fibrillation, but it is not the immediate priority over defibrillation.

A. Deaths from patients with communicable diseases do not need to be reported to organ procurement agencies. B. Tissue donation is involuntary. C. Organ donation can be authorized by a client's surrogate. D. Each organ donation request should be reported to a facility's committee.

Correct Answer is C

Explanation

A. Deaths of patients with communicable diseases still need to be reported because tissue and organ viability must be assessed on a case-by-case basis.

B. Tissue donation is voluntary and requires consent from the patient or their legal representative.

C. Organ donation can be authorized by a client's surrogate if the client has not previously given or refused consent. This allows for the surrogate to make decisions in line with the client’s wishes or best interests.

D. While facilities may have committees involved in the process, reporting is to organ procurement organizations, not solely to a facility's committee.

A nurse is caring for a client who has heart failure.

<div id="exhibits">Exhibits</div>

For each potential provider's prescription, click to specify if the prescription is essential (high priority) non-essential (low priority) or contraindicated(unrelated) for the client.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority?

Correct Answer is B

Explanation

A nurse is teaching a class about organ donation. Which of the following information should the nurse include?

Correct Answer is C

Explanation

A nurse is caring for a client who has heart failure. <div id="exhibits">Exhibits</div> For each potential provider's prescription, click to specify if the prescription is essential (high priority) non-essential (low priority) or contraindicated(unrelated) for the client.

The patient presents to the ED with severe chest discomfort. A cardiac catheterization and angiography shows an 90% occlusion of the left main coronary artery. Which procedure will be most likely performed on this patient?

A patient who has been in the intensive care unit for 4 days has disturbed sensory perception from sleep deprivation. Which action should the nurse include in the plan of care?

The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

A patient is being treated for hypertensive emergency. When treating this patient, the nurse recognizes the initial goal is to lower the mean blood pressure (BP) by 20-25% because

Which laboratory test result will the nurse review to determine the effects of therapy for a patient being treated for heart failure?

A patient is having a cardiac evaluation to assess for possible heart failure and valvular disease. Which study best identifies heart function and measures the size of the cardiac chambers?

Which clinical manifestations are indicative of right ventricular failure? (Select all that apply.)