After exercising, a client is hooked up to a cardiac monitor. The rhythm below is noted. How should the nurse document this rhythm?

Junctional tachycardia

Sinus tachycardia

Atrial flutter

Ventricular fibrillation

Answer and Explanation

The Correct Answer is B

A. Junctional tachycardia: Junctional tachycardia originates from the atrioventricular (AV) node, with a faster rate and usually no visible P waves preceding the QRS complexes.

B. Sinus tachycardia: Sinus tachycardia is characterized by a regular, rapid heart rhythm originating from the sinus node, typically seen after exercise, with identifiable P waves before each QRS complex.

C. Atrial flutter: Atrial flutter presents with a “sawtooth” pattern of P waves, indicating rapid atrial contractions, which is different from sinus tachycardia.

D. Ventricular fibrillation: Ventricular fibrillation is a chaotic and irregular rhythm originating from the ventricles, which is a life-threatening condition.

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Correct Answer is B

Explanation

A. Hold the medication and notify the HCP: This is unnecessary. An INR of 2.7 is within the therapeutic range for a client with a mechanical valve replacement (2.5 to 3.5). No intervention is required.

B. Administer the medication as ordered: The INR of 2.7 is within the desired therapeutic range for clients on warfarin with mechanical valve replacements, so the nurse should proceed with the prescribed dose.

C. Prepare to administer vitamin K (AquaMephyton): Vitamin K is used to reverse the effects of warfarin if the INR is too high (usually greater than 5).

D. Assess the client for abnormal bleeding: While important, this is not the first action. The INR is within the therapeutic range, so the priority is to administer the medication.

A. Propranolol B. Procainamide C. Aspirin D. Warfarin

Correct Answer is D

Explanation

A. Propranolol: This is a beta-blocker, which may be used to control heart rate, but it does not address the risk of thromboembolism in atrial fibrillation.

B. Procainamide: This is an antiarrhythmic used for rhythm control, but it does not address stroke prevention in atrial fibrillation.

C. Aspirin: Although aspirin is sometimes used for stroke prevention, it is generally less effective than anticoagulation therapy in clients with higher CHA2DS2-VASC scores.

D. Warfarin: A CHA2DS2-VASC score of 2 indicates a moderate risk for stroke, and warfarin (or another anticoagulant) is indicated to reduce the risk of thromboembolic events.

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After exercising, a client is hooked up to a cardiac monitor. The rhythm below is noted. How should the nurse document this rhythm?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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