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You are caring for this team of patients. Which patient is the priority to see first to collect data?

80-year-old male patient with a history of atrial fibrillation with rapid ventricular response whose cardiac monitor shows a heart rate of 92

66-year-old female patient with a newly inserted permanent pacemaker whose cardiac monitor shows a heart rate of 50

72-year-old male patient with an implantable cardiac defibrillator that delivered a shock 4 hours ago whose cardiac monitor shows normal sinus rhythm and a heart rate of 68

78-year-old male patient with chronic atrial fibrillation who is prescribed metoprolol (Toprol) whose cardiac monitor shows a heart rate of 58.

Answer and Explanation

The Correct Answer is B

A.   While atrial fibrillation with a rapid ventricular response requires attention, it is not an immediate concern unless associated with symptoms such as chest pain, shortness of breath, or hemodynamic instability.
B.   A heart rate of 50 in a patient with a newly inserted permanent pacemaker may indicate bradycardia, which could be a sign of pacemaker malfunction or lead dislodgement. This patient requires immediate assessment to rule out complications.
C.   While recent implantable cardioverter-defibrillator (ICD) discharge warrants evaluation, the patient is currently in normal sinus rhythm with a heart rate of 68, suggesting stability. This patient's assessment can be prioritized after the patient with the pacemaker issue is seen.
D.   A heart rate of 58 in a patient with chronic atrial fibrillation on beta-blocker therapy may not be immediately concerning if the patient is asymptomatic and hemodynamically stable. This patient can be assessed after addressing the more urgent pacemaker issue.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Jaundice is typically not visible in the webbed areas of the fingers.

B. The nail beds are part of the skin that can show jaundice, but they may also be aﬀected by other factors such as anemia, cyanosis, or nail polish.
C. The hard palate is a part of the oral mucosa that can show jaundice, especially in clients with dark skin tones.
D. This is not an area that the nurse should inspect to monitor for the presence of jaundice in a client who is African American and has cholecystitis. The skin can show jaundice, but it may be difficult to detect in clients with dark skin tones.

A. Atrial fibrillation B. Asystole C. Ventricular fibrillation D. Atrial flutter

Correct Answer is B

Explanation

A. Atrial fibrillation is characterized by rapid, irregular electrical impulses originating from the atria, resulting in a quivering or fibrillating motion of the atria rather than a coordinated contraction.
B. Asystole is the absence of any electrical activity on the cardiac monitor, resulting in a flat line. It indicates the absence of ventricular contraction and is considered a medical emergency requiring immediate intervention (CPR and advanced cardiac life support).
C. Ventricular fibrillation is characterized by chaotic, disorganized electrical activity in the ventricles, resulting in ineffective quivering of the ventricles and loss of cardiac output.
D. Atrial flutter is characterized by rapid but regular electrical impulses originating from the atria, resulting in a sawtooth pattern on the ECG tracing.

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You are caring for this team of patients. Which patient is the priority to see first to collect data?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is African American has cholecystitis. Which of the following areas should the nurse inspect to monitor for the presence of jaundice?

Correct Answer is C

Explanation

The nurse is caring for a patient whose cardiac monitor shows a total absence of electrical impulse as indicated by a flat line. The nurse does not detect a pulse or blood pressure. The nurse would document this as which of the following rhythms?

Correct Answer is B

Explanation

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You are caring for this team of patients. Which patient is the priority to see first to collect data?

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A patient reporting palpitations has multiple premature ventricular contractions (PVCS) on an electrocardiogram (ECG) tracing. Which patient statement Indicates teaching is effective?

A nurse is reinforcing dietary instructions with a client who has chronic kidney disease. Which of the following information should the nurse include?