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. Heart failure often presents with dyspnea, crackles (from pulmonary congestion), jugular vein distention, dependent edema, and hepatomegaly due to fluid overload and impaired cardiac output—these are classic signs.
B. Pulmonary embolism typically causes sudden dyspnea, chest pain, and tachypnea but not hepatomegaly or dependent edema.
C. Tension pneumothorax presents with tracheal deviation, absent breath sounds on one side, and hypotension—different from the systemic fluid overload signs described.
D. Cardiac tamponade presents with muffled heart sounds, hypotension, and jugular vein distention (Beck's triad), but it does not cause crackles, hepatomegaly, or peripheral edema.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
Explanation
The nurse should monitor the client for pneumothorax and lead dislodgement following permanent pacemaker placement.
Rationale
Pneumothorax: The procedure involves central venous access, often via the subclavian vein, which increases the risk of puncturing the pleura and causing a pneumothorax. Signs include:
Lead dislodgement: Movement or tension on the pacing lead can result in loss of pacemaker capture or failure to pace effectively. This is a priority during the first 24 hours. Indicators include:
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