Nokea
Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?
- A. Diuretic
- B. Anticoagulant
- C. Antihypertensive
- D. Potassium supplement
Correct Answer: B
Rationale: Clients with persistent atrial fibrillation are prescribed anticoagulation therapy to reduce the risk of emboli formation associated with ineffective circulation. The other options may be prescribed but not expected in most situations.
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The nursing student is taking a pre-nursing pharmacology class. Today, the nursing student is learning about antiarrhythmic drugs. What drug is a potassium channel blocker?
- A. Amiodarone
- B. Lidocaine
- C. Flecainide
- D. Isoproterenol
Correct Answer: A
Rationale: Potassium channel blockers include amiodarone and bretylium tosylate. Lidocaine and flecainide are sodium channel blockers. Isoproterenol is a beta-blocker.
The nurse is caring for a client with an arrhythmia. While assessing the data in the history of the chart, the nurse anticipates the cause of the arrhythmia to be which of the following?
- A. Peripheral vascular disease
- B. Ischemic heart disease
- C. Aortic stenosis
- D. Atherosclerotic heart disease
Correct Answer: B
Rationale: The nurse realizes that the most common cause of arrhythmias is ischemic heart disease. When the heart does not obtain sufficient blood to meet demands, the heart works harder to circulate body fluids and becomes inefficient in the process. Problems with the peripheral vessels, narrowing of the aorta and plaque build-up in the vessels may be a component of the disease process but not the best answer.
Which of the following does the nurse recognize as the therapeutic goal of radiofrequency catheter ablation for a client with cardiac arrhythmias?
- A. Reperfusion of ischemic heart tissue
- B. Dilation of arterial blood vessels
- C. Destruction of errant tissue
- D. Stimulation of the impulse center
Correct Answer: C
Rationale: The therapeutic goal of radiofrequency catheter ablation is to destroy errant tissue, in hopes of allowing impulse conduction to travel over appropriate pathways. The goal does not include dilation of blood vessels or reperfusion of heart tissue. There is no stimulation of the heart.
The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated?
- A. The registered nurse stating to administer digoxin
- B. The registered nurse administering atropine sulfate intravenously
- C. The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute
- D. The registered nurse stating to administer all medications except those which are cardiotonics
Correct Answer: B
Rationale: The licensed practical nurse and registered nurse both identify that client's bradycardia. Atropine sulfate, a cholinergic blocking agent, is given intravenously (IV) to increase a dangerously slow heart rate. Lanoxin is not administered when the pulse rate falls under 60 beats/minute. It is dangerous to wait until the pulse rate increases without nursing intervention or administering additional medications until the imminent concern is addressed.
The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?
- A. Heart rate between 60 and 150 beats/minute.
- B. Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second.
- C. The ventricles depolarize in 0.5 second or less.
- D. The sinoatrial (SA) node initiates the impulse.
Correct Answer: D
Rationale: The characteristics of normal sinus rhythm are heart rate between 60 and 100 beats/minute, the SA node initiates the impulse, the impulse travels to the AV node in 0.12 to 0.2 second, the ventricles depolarize in 0.12 seconds or less, and each impulse occurs regularly.