MI and dysrhythmia practice
A client has been admitted to the coronary care unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60. The nurse should take which of the following actions first? A. Prepare for transcutaneous pacing B. Prepare to defibrillate the client at 200 J C. Administer an IV lidocaine infusion D. Schedule the operating room for insertion of a permanent pacemaker
A
When teaching a client about self-care following placement of a new permanent pacemaker to the upper left chest, the nurse should include which information? A. Take and record daily pulse rate B. Avoid air travel because of airport security alarms C. Immobilize the affected arm for 4 to 6 weeks D. Avoid using a microwave oven
A
When teaching the client about complications of atrial fibrillation, the nurse should instruct the client to avoid which of the following? A. Stasis of blood in the atria B. Increased cardiac output C. Decreased pulse rate D. Elevated blood pressure
A
The nurse has completed an assessment on a client with a decreased cardiac output. Which findings should receive highest priority? A. BP 110/62, atrial fibrillation with HR of 82, bibasilar crackles B. Confusion, urine output 15 mL over the last 2 hours, orthopnea C. SpO2 92% on 2 L nasal cannula, respirations 20, 1+ edema on lower extremities D. Weight gain of 1 kg in 3 days, BP 130/80, mild dyspnea with exercise
B
Which of the following is the most appropriate diet for a client during the acute phase of an NSTEMI? A. Liquids as desired B. Small, easily digested meals C. Three regular meals a day D. Nothing by mouth
B
The nurse notices that a client's heart rate decreases from 63 to 50 bpm on the monitor. The nurse should first: A. Administer atropine 0.5 mg IV push B. Auscultate for abnormal heart sounds C. Prepare for transcutaneous pacing D. Take the clients blood pressure
D
Which of the following is an expected outcome for a client on the second day of hospitalization after an MI? the client: A. Continues to have severe chest pain B. Can identify risk factors for MI C. Participates in a cardiac rehabilitation walking program D. Can perform personal self-care activities without pain
D
An older adult is admitted to the telemetry unit for placement of a permanent pacemaker because of sinus bradycardia. A priority goal for the client within 24 hours after insertion of a permanent pacemaker is to: A. Maintain skin integrity B. Maintain cardiac conduction stability C. Decrease cardiac output D. Increase activity level
B
During physical assessment, the nurse should further assess the client for signs of atrial fibrillation when the palpation of the radial pulse reveals: A. Two regular beats followed by one irregular beat B. An irregular rhythm with pulse greater than 100 C. Pulse rate below 60 D. A weak, thread pulse
B
While caring for a client who has sustained a myocardial infarction, the nurse notes 8 premature ventricular contractions in 1 minute on the cardiac monitor. The client is receiving an IV infusion of 5% dextrose in water and oxygen at 2 L/min. The nurse's first course of action should be to: A. Increase the IV infusion rate B. Notify the physician promptly C. Increase the oxygen concentration D. Administer a prescribed analgesic
B
