A patient's heart monitor shows HR 78 with progressive lengthening of the PR interval over time. What is the most appropriate action for the nurse to take next?
Notify the healthcare provider about the changes in PR interval.
increase the patient's activity level to stimulate heart rate.
Administer metoprolol as scheduled.
initiate atropine administration to increase heart rate.
The Correct Answer is A
Rationale:
A. Progressive lengthening of the PR interval indicates a first-degree or potentially worsening second-degree AV block. Notifying the provider is essential to prevent further conduction deterioration and potential progression to complete heart block, which can be life-threatening.
B. Increasing activity could exacerbate bradycardia or AV block symptoms (e.g., dizziness, syncope) and is unsafe in this context.
C. Beta-blockers like metoprolol can further slow AV conduction, potentially worsening the block, so giving it without provider consultation is unsafe.
D. Atropine is indicated for symptomatic bradycardia, but this patient currently has a normal HR (78) and is asymptomatic. Immediate administration is not warranted; the priority is assessment and provider notification.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Cardiac enzyme tests indicate myocardial injury but do not pinpoint the exact location of the infarct; imaging or ECG is required for localization.
B. Cardiac enzymes, such as troponin and creatine kinase-MB (CK-MB), are released into the bloodstream when myocardial cells are damaged. Their levels correlate with the extent of cardiac tissue injury, helping providers assess severity and guide treatment.
C. Pulmonary congestion is assessed via physical examination, chest X-ray, or echocardiography, not cardiac enzyme levels.
D. Structural assessment requires echocardiography or other imaging, not blood enzyme studies.
Correct Answer is A
Explanation
Rationale:
A. This statement is accurate. Infective endocarditis occurs when bacteria or other pathogens in the bloodstream attach to damaged areas of the endocardium or heart valves, leading to vegetation formation and potential systemic complications.
B. This is incorrect because anyone with predisposing factors, such as prosthetic heart valves, previous endocarditis, or certain cardiac lesions, can develop endocarditis. It is not limited to children or congenital heart disease.
C. This is incorrect because infective endocarditis can have systemic effects, including septic emboli, stroke, renal infarction, and other organ involvement.
D. While immunocompromised patients are at increased risk, endocarditis can occur in any patient with susceptible cardiac endothelium or exposure to pathogens, regardless of age or immune status.
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