A male client with a history of asthma reports having episodes of bronchoconstriction and increased mucous production while exercising. Which action should the nurse implement?
- A. Determine if the client is using an inhaler before exercising
- B. Advise the client to avoid all physical activity
- C. Encourage the client to increase fluid intake before exercise
- D. Recommend the client wear a mask while exercising
Correct Answer: A
Rationale: Using an inhaler before exercise can help manage asthma symptoms by preventing bronchoconstriction during physical activity.
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A client's telemetry monitor indicates ventricular fibrillation (VF). After delivering one counter shock, the nurse resumes chest compression. After another minute of compressions, the client's rhythm converts to supraventricular tachycardia (SVT) on the monitor. At this point, what is the priority intervention for the nurse?
- A. Prepare for transcutaneous pacing
- B. Deliver another defibrillator shock
- C. Administer IV Epinephrine per ACLS protocol
- D. Give IV dose of adenosine rapidly over 1-2 seconds
Correct Answer: D
Rationale: SVT can be treated by rapidly administering adenosine to restore normal sinus rhythm.
The following procedures may abort an attack of SVT EXCEPT
- A. placing of the face in ice water
- B. straining
- C. breath holding
- D. standing on head
Correct Answer: D
Rationale: Standing on the head is not a practical or effective method to terminate SVT.
In Wolff-Parkinson-White syndrome:
- A. The abnormal pathway is between the atrial and ventricular myocardium
- B. Wide QRS complexes occur more frequently than narrow QRS
- C. Narrow QRS complexes are regular
- D. Verapamil is the treatment of choice for atrial fibrillation
Correct Answer: B
Rationale: In Wolff-Parkinson-White syndrome, a wide QRS complex is often seen due to the presence of an accessory pathway that bypasses the normal conduction system.
A 3-month-old infant who was previously healthy now has a persistent cough, bilateral lung crackles, and poor appetite. A grade III/VI, low-pitched, holosystolic murmur over the left lower sternal border and palpates the liver at one centimeter below the ribs. What diagnosis is likely?
- A. Atrial septal defect (ASD)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosis (PDA)
- D. Ventricular septal defect (VSD)
Correct Answer: D
Rationale: The symptoms above are characteristic of a VSD and may not present at birth but appear later as CHF becomes more pronounced.
The most common indication of heart transplantation in the neonate is
- A. Hypoplastic left heart syndrome
- B. Hypoplastic right heart syndrome
- C. Severe Ebstein's anomaly
- D. Dilated cardiomyopathy
Correct Answer: A
Rationale: Hypoplastic left heart syndrome is the most common indication for heart transplantation in neonates.