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HESI Med Surg 1 Exam Questions and Answers 2023
(Verified Answers)
- The nurse observes ventricular fibrillation on telemetry and, on entering
the client’s bathroom, finds the client unconscious on the floor. Which
interven- tion should the nurse implement first?
A.
Administer an antidysrhythmic
medication. B.
Start cardiopulmonary resuscitation.
C.
Defibrillate the client at 200
J. D.
Assess the client’s pulse oximetry.
ANS : B. Start cardiopulmonary
resuscitation.
Rationale:
Ventricular fibrillation is a life-threatening dysrhythmia, and CPR shouldbe started immediately (B). (A and C) are appropriate, but CPR is thepriority action. The client is dying, and (D) does not address theseriousness of this situation.
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- The nurse assesses a client who has been prescribed furosemide
(Lasix) for cardiac disease. Which electrocardiographic change would be a
concern for a client taking a diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT
interval C.
A widening QRS complex
D.
Presence of a U wave
ANS : D . Presence of a
U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often
present with hypokalemia (low potassium level). (A, B, and C) are all
signs of hyperkalemia. - A 43-year-old homeless, malnourished female client with a history of
alco- holism is transferred to the ICU. She is placed on telemetry, and the
rhythm strip shown is obtained. The nurse palpates a heart rate of 160
beats/min, and the client’s blood pressure is 90/54 mm Hg. Based on these
findings, which IV medication should the nurse administer?
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A.
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Amiodarone
(Cordarone) B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl)
ANS : B. Magnesium
sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have
hypomagnesemia.
(B)is the recommended drug for torsades de pointes, which is a form of
polymorphic ventricular tachycardia (VT) usually associated with a
prolonged QT interval that occurs with hypomagnesemia. (A and D)
increase the QT interval, which can cause the torsades to worsen. (C) is the antiarrhythmic of choice in most cases of drug-induced
monomorphic VT, not torsades.
- When developing a discharge teaching plan for a client after the
insertion of a permanent pacemaker, the nurse writes a goal of “The client
will verbalize symptoms of pacemaker failure.” Which behavior indicates
that the goal has been met?
A.