Mr Jones came to the ER complaining of chest palpitations. He states his heart feels like it is "racing". The nurse found the following rhythm on the monitor. What is the next step would the nurse expect to take first?

Defibrillate

Ask him to blow into a syringe

Draw troponins

Give amiodarone

Answer and Explanation

The Correct Answer is B

B This maneuver, called the Valsalva maneuver, can sometimes help to restore normal heart rhythm in cases of SVT. It involves blowing forcefully into a syringe or performing a similar action that increases intra-abdominal pressure, which can stimulate the vagus nerve and help to slow down the heart rate.

A Defibrillation is a treatment used for life-threatening cardiac arrhythmias, particularly ventricular fibrillation or pulseless ventricular tachycardia. It involves delivering a therapeutic dose of electrical energy to the heart with a device called a defibrillator.

C Drawing troponin levels may be appropriate if there is suspicion of myocardial infarction as the cause of chest palpitations or if there are other symptoms suggestive of acute coronary syndrome. However, in the context of SVT presenting with chest palpitations and a racing heart, the priority is to address the arrhythmia first

D Amiodarone is an antiarrhythmic medication used to treat various types of cardiac arrhythmias, including ventricular and supraventricular arrhythmias. While it can be effective in certain cases of SVT, it is not typically the first-line treatment or the immediate next step in managing SVT in the emergency department.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

D. Assessing the patient's level of consciousness (LOC) is essential to determine their neurological status and assess for any signs of deterioration. Changes in LOC could indicate worsening sepsis, hypoperfusion, or other underlying issues that require immediate attention.

A. Administering amiodarone, an antiarrhythmic medication, is not the first action to take in this situation. While amiodarone may be used to manage certain arrhythmias, its use should be based on a thorough assessment and specific arrhythmia diagnosis. In this case, with only three seconds of PVCs followed by sinus tachycardia, immediate administration of amiodarone is not warranted.

B. Carotid massage is not indicated in this scenario. Carotid massage is typically used to slow down or terminate supraventricular tachycardias (SVTs), such as paroxysmal supraventricular tachycardia (PSVT). However, it is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), carotid artery disease, or recent myocardial infarction (MI). Furthermore, PVCs are not typically responsive to carotid massage.

C. Administering Tylenol (acetaminophen) may be appropriate in this situation. The patient's elevated temperature (101.1°F) suggests the presence of fever, which could contribute to the patient's tachycardia. Lowering the fever with acetaminophen may help reduce the heart rate and alleviate symptoms associated with fever, such as discomfort.

A. Different blood pressures in the upper limbs. B. Differences in upper and lower lung sounds. C. Differences between oral and axillary temperatures. D. Different apical and radial pulses.

Correct Answer is D

Explanation

D. Atrial fibrillation can lead to irregular and often rapid heart rates, resulting in discrepancies between the apical (heart) and radial (peripheral) pulses. In atrial fibrillation, the atria fibrillate instead of contracting effectively, leading to irregular and sometimes asynchronous ventricular contractions. This irregularity may result in a pulse deficit, where the number of apical beats exceeds the number of radial pulses felt at the wrist.

A. Different blood pressures in the upper limbs may indicate conditions such as aortic dissection or arterial stenosis, but they are not typically associated with atrial fibrillation. Atrial fibrillation primarily affects the heart rhythm rather than blood pressure distribution.

B. Differences in upper and lower lung sounds may indicate conditions such as pneumonia or pleural effusion, but they are not specific to atrial fibrillation. Atrial fibrillation primarily affects the heart's electrical activity rather than respiratory findings.

C. Differences between oral and axillary temperatures may indicate localized variations in temperature, such as infection or inflammation, but they are not specific to atrial fibrillation. Atrial fibrillation primarily affects cardiac rhythm rather than body temperature regulation.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Mr Jones came to the ER complaining of chest palpitations. He states his heart feels like it is "racing". The nurse found the following rhythm on the monitor. What is the next step would the nurse expect to take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient admitted with urosepsis and alcohol abuse had three seconds of PVCS and returns to sinus tachycardia. The patient's baseline heart rate ie 116/ min with a temperature of 101.1F, respirations of 22/min and blood pressure is 114/64. What should the nurse anticipate to do first?

Correct Answer is D

Explanation

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation?

Correct Answer is D

Explanation

A client with acute respiratory distress syndrome (ARDS) shows no improvement despite increases in concentration in oxygen administered. What intervention should the nurse attempt which may improve ventilation-perfusion matching?

A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGS? pH 7.22 PaCO2 68 mm Hg Base excess-2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Which is(are) potential result(s) of end-organ damage from chronic hypertension? (Select all that apply.)

A nurse is caring for a client who is in the compensatory stage of shock. Which of the following findings should the nurse expect?

A client tells the nurse that he is concerned because his provider told him he has a heart murmur. The nurse should explain to the client that a murmur

A patient who has neurogenic shock is receiving a dobutamine infusion through a right forearm IV. Which assessment finding obtained by the nurse indicates a need for immediate action?

The nurse is caring for a client with a history of heart failure and notes a new onset of the following rhythm on the client's telemetry monitor. Which action would the nurse take first?