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.
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
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Tight fitting clothes may put pressure on the T-tube insertion site and interfere with drainage. Loose-fitting clothing is recommended.
B. Showering is typically preferred over baths to keep the T-tube site clean and dry.
Baths may increase the risk of infection.
C. Regular emptying of the drainage bag helps prevent excessive weight, which can pull on the T-tube and cause discomfort or displacement. However, it should necessarily be emptied at the same time each day.
D. Securing the tubing to clothing helps prevent accidental dislodgment or pulling on the T-tube, reducing the risk of complications.
Correct Answer is ["A","B","D"]
Explanation
A. Irregularly irregular: Atrial fibrillation is characterized by an irregularly irregular rhythm.
B. No identifiable P waves: P waves are typically absent in atrial fibrillation or may be difficult to identify.
C. PR interval is not typically measured in atrial fibrillation as it is not relevant to the rhythm.
D. Atrial rate not measurable: The atrial rate in atrial fibrillation is not measurable due to the rapid and irregular nature of the rhythm.
E. QRS interval is typically normal in atrial fibrillation and does not exceed 0.10 seconds.
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