The nurse is caring for a client who suddenly develops bradycardia. The client is breathing but with a decreased level of consciousness and decreased blood pressure. Which of the following treatments would be done by the nurse first?
Application of a transcutaneous pacemaker
Administer atropine IV
Begin CPR
Initiate cardioversion
The Correct Answer is B
A. Transcutaneous pacing may be considered if the bradycardia does not respond to initial medical management, but it is not the first intervention.
B. Administering atropine IV is the first-line treatment for symptomatic bradycardia. Atropine works by increasing heart rate through its anticholinergic effects, helping to improve cardiac output and consciousness.
C. CPR is only indicated if the client is pulseless or not breathing. Since this client is still breathing, CPR is not appropriate at this stage.
D. Cardioversion is used for certain tachyarrhythmias (e.g., atrial fibrillation with rapid ventricular response), not for bradycardia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Epinephrine – Epinephrine is the first-line treatment for anaphylactic shock. It rapidly reverses airway constriction, hypotension, and swelling by stimulating alpha and beta-adrenergic receptors, leading to bronchodilation, vasoconstriction, and increased cardiac output.
B. Dobutamine – Dobutamine is a positive inotrope used to treat cardiogenic shock and may support cardiac output, but it does not address the airway or allergic component of anaphylaxis.
C. Methylprednisolone – This corticosteroid may be given to reduce inflammation and prevent delayed reactions, but it has a slower onset of action and is not the priority in emergency management.
D. Furosemide – This diuretic is used in fluid overload or pulmonary edema, not in the management of anaphylaxis.
Correct Answer is D
Explanation
A. A murmur and splinter hemorrhages are expected findings in infective endocarditis and do not indicate an immediate life-threatening condition.
B. Sharp chest pain with inspiration in rheumatic fever may indicate pericarditis, which needs monitoring but is not immediately unstable.
C. Bilateral crackles suggest fluid overload in dilated cardiomyopathy, requiring attention, but not as urgent as hypotension in acute valve failure.
D. Acute aortic regurgitation with hypotension (BP 86/54 mm Hg) indicates a possible hemodynamic collapse and cardiogenic shock, making this client the highest priority for immediate assessment and intervention.
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