Which of the following is the initial step in the management of a patient with asystole?
Check for a pulse every 30 seconds
Administer 1 mg of epinephrine
Administer a defibrillation shock
Begin chest compressions immediately
The Correct Answer is D
Rationale:
A. In a patient with asystole, a pulse check is not performed repeatedly in 30-second intervals; the rhythm is already pulseless, so delaying intervention to check the pulse wastes critical time.
B. Epinephrine is an important medication in asystole management, but it is administered after initiating CPR, not as the first step. Immediate medication without circulation is ineffective.
C. Defibrillation is ineffective in asystole because there is no organized electrical activity to reset. Defibrillation is reserved for shockable rhythms such as ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT).
D. This is the correct initial step because asystole represents a complete absence of cardiac electrical activity, and immediate high-quality CPR is essential to maintain circulation and oxygen delivery to vital organs. Early initiation of chest compressions increases the chance of survival while advanced life support measures (airway, epinephrine) are prepared.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. These tiny red or purple spots are caused by microvascular emboli or vascular fragility associated with infective endocarditis. While they indicate ongoing infection, they are primarily diagnostic and usually do not pose an immediate threat to the patient’s airway, breathing, or circulation.
B. Fever reflects the systemic inflammatory response to the bacterial infection and is a common finding in endocarditis. While it needs monitoring and management with antipyretics or antibiotics, it does not require emergent action unless accompanied by hemodynamic instability or signs of sepsis.
C. These linear, dark streaks are a classic sign of embolic events in infective endocarditis. They are important diagnostic clues but are not acutely dangerous, and immediate intervention is usually not required.
D. This is the priority finding because it may indicate acute complications of infective endocarditis such as heart failure from valvular dysfunction, pulmonary embolism from septic emboli, or pneumonia secondary to infection. Dyspnea reflects compromised oxygenation or cardiac function, which can quickly become life-threatening. According to the ABC principle (Airway, Breathing, Circulation), respiratory distress takes precedence over other manifestations and requires prompt assessment and intervention.
Correct Answer is B
Explanation
Rationale:
A. While infection monitoring is important, the risk immediately post-procedure is low; infection typically develops later, not immediately.
B. Immediately following a heart catheterization, there is a risk of arrhythmias, bleeding, or hemodynamic instability, making continuous monitoring of cardiac rhythm and vital signs critical to detect complications early.
C. Routine glucose monitoring is not specifically indicated unless the patient has diabetes; it is not a priority related to the catheterization procedure.
D. While ongoing hydration and diet are part of overall care, they are not immediate priorities in the immediate post-catheterization period.
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