The nurse is providing discharge instructions to a 76-year-old male client with chronic atrial fibrillation who has a CHA2DS2-VASC score of 2. Which medication would the nurse identify as most likely to be prescribed for the client?
Propranolol
Procainamide
Aspirin
Warfarin
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Bring the crash cart to the bedside: Essential for advanced cardiac life support (ACLS), including defibrillation and medications.
B. Start cardiopulmonary resuscitation: High-quality CPR is critical to maintain circulation until defibrillation can occur.
C. Defibrillate the client: Defibrillation is the definitive treatment for ventricular fibrillation to restore a normal rhythm.
D. Administer adenosine (Adenocard) to assist in determining the rhythm: Adenosine is used for diagnosing or treating certain supraventricular tachycardias, not ventricular fibrillation.
E. Consider the "Hs and Ts": Identifying reversible causes of cardiac arrest (e.g., hypoxia, hypothermia, toxins) is part of the ACLS protocol.
Correct Answer is D
Explanation
A. Subdural hematoma: Subdural hematomas develop more slowly and typically present a higher risk for delayed deterioration, but not usually within the first 24 hours.
B. Diffuse axonal injury: While severe, diffuse axonal injury typically causes a prolonged coma rather than immediate fatality within 24 hours.
C. Intracranial hemorrhage: This is severe but often depends on the size and location of the bleed.
D. Epidural hematoma: Epidural hematomas are associated with arterial bleeding and rapid deterioration due to increased intracranial pressure, making them the most fatal within 24 hours.
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