MedSurg Exam 2 Lewis Questions And Answers 2024

Cardioversion is attempted for a patient with artial flutter and a rapid ventricular response. After delivering 50 joules by synchronized cardioversion, the patient develops ventricular fibrillation. Which action should the nurse take immediately? a.) Administer 250 mL of 0.9% saline solution by rapid bolus b.) Assess the apical pulse, BP, and bilaterak vein distention c.) Turn the synchronized switch to the "off" position and recharge the device d.) Ask the patient if there is any chest discomfort and administer morphine sulfate - correct answer-c When computing the heart rate from the ECG tracing, the nurse counts 15 of the small blocks between the R waves of a patient who rhythm is regular. What does the nurse calculate the heart rate to be? a.) 60 beats/min b.) 75 beats/min c.) 100 beats/min d.) 150 beats/min - correct answer-c The nurse determines there is artifact on the patient's telemetry monitor. Which factor should the nurse assess for that could correct this issue? a.) disabled automaticity b.) Electrodes in the wrong lead c.) Too much hair under the elctrodes d.) Stimulation of the vagus nurve fibers - correct answer-c A patient develops third-degree heart block and reports feeling chest pressure and SOB. Which instructions should the nurse provide the patient before initiating emergency transcutaneous pacing? a.) "The device will convert your heart rate and rhythm back to normal." b.) "The device uses overdrive pacing to slow the heart to a normal pace." c.) "This device is inserted to a large vein and threaded into your heart." d.) "The device delivers a curren t through your skin that can be uncomfortable." - correct answer-d The patient has atrial fibrillation with a rapid ventricular response. What electrical treatment option does the nurse prepare the patient for? a.) Defibrillation b.) Synchronized cardioversion c.) Automatic external defibrillator (AED) d.) Implantable cardioverter-defibrillator - correct answer-b The patient has a potassium level of 2.9 mEq/L, and the nurse obtains the following measurements on the rhythm strip: Heart rate 86 with a regular rhythm, the P wave is 0.06 seconds and normal shape, the PR interval is 0.24 seconds, and the QRS is 0.09 seconds. How should the nurse document this rhythm? a.) first degree AV block b.) second degree AV block c.) Premature atrial contraction (PAC) d.) Premature ventricular contraction (PVC) - correct answer-a The nurse observes ventricular tachycardia (VT) on the patient's monitor. What evaluation made by the nurse led to this interpretation? a.) Unmeasuable rate and rhythm b.) Rate 150 beats/min; inverted P wave c.) Rate 200 beats/min; P wave not visable d.) Rate 125 beats/min; normal QRS complex - correct answer-c The nurse observes a flat line on the patient's monitor and the patient is unresponsive without a pulse. What medications does the nurse prepare to administer? a.) Lidocaine or amiodarone b.) Dogoxin and procainamide c.) Epinephrine or vassopressin d.) Beta adrenergic blocker and dopamine - correct answer-c