Try Naxlex NCLEX-RN (Free-Trial)

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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. The QRS interval may vary but is typically less than 0.12 seconds in normal sinus rhythm.
B. Normal sinus rhythm typically has a heart rate between 50 and 100 beats per minute.
C. In normal sinus rhythm, P waves are typically upright and precede each QRS complex.
D. The PR interval may vary but is typically between 0.12 and 0.20 seconds in normal sinus rhythm.

A. Drape the biopsy site. B. Observe the patient for bleeding. C. Explain the procedure to the patient's family. D. Administer an analgesic to the patient.

Correct Answer is D

Explanation

A. While draping is essential for maintaining sterility, it's typically done right before the physician performs the biopsy, not as a primary pre-procedure step for the nurse.
B. Monitoring for bleeding is important after the procedure, not necessarily beforehand.
C. Although informing the family can be helpful, the patient's understanding and consent are the top priority. Pain management is crucial for patient comfort and cooperation during the procedure.
D. Administering an analgesic helps reduce the patient's anxiety and discomfort during the bone marrow biopsy, which can be a painful procedure. This improves patient tolerance and allows the physician to perform the procedure more efficiently.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

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

The nurse is reviewing a patient's electrocardiogram (ECG) tracing. Which of the following are characteristics of normal sinus rhythm (NSR?

Correct Answer is B

Explanation

The nurse is preparing to assist the physician with a bone marrow biopsy. Which intervention is most important for the nurse to carry out before the procedure?

Correct Answer is D

Explanation

Which of the following is the best indicator of fluid balance in the body?

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?

A nurse is collecting data from a client who has leukemia. Which of the following findings has the highest priority?

A nurse is caring for a client who has cholelithiasis with bile duct obstruction. The nurse should expect which of the following findings when obtaining the client's urine specimen?

A nurse is reviewing the urinalysis results of a client who reports urinary frequency and burning. Which of the following findings should the nurse report to the provider?

After reviewing an electrocardiogram, the nurse determines that an electrical impulse originated in a patient's sinoatrial (SA) node with a P wave. What does this represent?

Which of the following are rules for atrial fibrillation? Select all that apply