Nokea
The nurse caring for a client with a history of atrial fibrillation is prescribed dofetilide to control the dysrhythmia. What assessment should the nurse prioritize before administering the medication?
- A. Daily weight
- B. Liver function tests
- C. QT interval on the electrocardiogram (ECG)
- D. Blood urea nitrogen (BUN) and creatinine levels
Correct Answer: C
Rationale: Dofetilide can prolong the QT interval, increasing the risk of torsades de pointes, so monitoring the ECG for QT prolongation is critical.
You may also like to solve these questions
Which interventions would be appropriate for a client with decreased cardiac output? Select all that apply.
- A. Apply compression stockings
- B. Obtain a prescription for nitroglycerin via transdermal patch
- C. Elevate the client's legs
- D. Implement fall precautions
- E. Educate the client about not straining when defecating
Correct Answer: A,D,E
Rationale: Compression stockings improve venous return, supporting cardiac output. B: Incorrect - Nitroglycerin reduces preload, potentially worsening cardiac output in some cases. C: Incorrect - Leg elevation is not standard for low cardiac output and may worsen symptoms. D: Correct - Fall precautions are needed due to potential weakness or syncope. E: Correct - Avoiding straining prevents Valsalva maneuver, which can reduce cardiac output.
Which of the following lifestyle modifications are recommended for managing essential hypertension? Select all that apply.
- A. Isometric exercises
- B. Decreasing sodium intake
- C. Smoking cessation
- D. Use of herbal supplements
- E. Weight loss
Correct Answer: B,C,E
Rationale: Isometric exercises can increase blood pressure and are not recommended. Reducing sodium intake helps lower blood pressure. C: Correct - Smoking cessation reduces cardiovascular risk. D: Incorrect - Herbal supplements are not universally recommended and may interact with medications. E: Correct - Weight loss reduces blood pressure and cardiovascular strain.
The following scenario applies to the next 1 items
The nurse cares for a client following a cardiac arrest
Item 1 of 1
Admission Notes
2000 - 36-year-old was found unresponsive and with no pulse after collapsing at his job. Cardiopulmonary resuscitation (CPR) was started at the scene. The client was successfully resuscitated in the emergency department. The client was intubated, and central vascular access was established.
2130 - The client was transferred to the intensive care unit. Shortly after the transfer, the client converted to ventricular fibrillation. Code blue was called. CPR was delivered over 2 minutes, and a palpable carotid pulse was not assessed. The client's current cardiac monitor shows asystole.
The next essential intervention is the administration of…………… followed by ……………….. for a client in asystole post-cardiac arrest.
- A. Epinephrine
- B. Amiodarone
- C. Sodium bicarbonate
- D. Defibrillation
- E. Resuming CPR
- F. Cardioversion
Correct Answer: A,E
Rationale: Epinephrine is given in asystole to stimulate cardiac activity. E: Correct - CPR resumes immediately after medication to restore circulation. B, C, D, F: Incorrect - Amiodarone, sodium bicarbonate, defibrillation, and cardioversion are not indicated for asystole.
The following scenario applies to the next 1 items
The nurse in the intensive care unit (ICU) is caring for 58-year-old male client
Item 1 of 1
Medical History Vital Signs Medication Administration Record
• atrial fibrillation
• chronic obstructive pulmonary disease
• hyperlipidemia
• chronic back pain
Based on the 2000 vital signs, select two (2) immediate actions the nurse should take for a client with atrial fibrillation, COPD, hyperlipidemia, and chronic back pain.
- A. Stop the diltiazem infusion
- B. Apply supplemental oxygen via nonrebreather face mask
- C. Stop the 0.9% saline infusion
- D. Notify the primary healthcare provider
- E. Assess the client for back pain
- F. Request a prescription to change the intravenous fluids to hypertonic saline
Correct Answer: B,D
Rationale: Supplemental oxygen addresses potential hypoxia from COPD or atrial fibrillation complications. D: Correct - Notifying the provider ensures timely management of abnormal vital signs. A, C, E, F: Incorrect - No vital sign data suggests stopping infusions, assessing back pain, or changing to hypertonic saline.
The nurse has performed a cardiovascular assessment on a client, and while auscultating heart tones, the nurse auscultates a harsh blowing sound. The nurse should document this finding as a
- A. pericardial friction rub.
- B. heart murmur.
- C. normal lub-dub sounds.
- D. S3 heart sound.
Correct Answer: B
Rationale: A harsh blowing sound indicates a heart murmur, caused by turbulent blood flow, often due to valve dysfunction.