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NCLEX STUDY SESSIONS (WEEK1 TO WEEK 4)
Week 1
The healthcare provider is performing an assessment on a patient who is taking
propranolol (Beta Blocker) for supraventricular tachycardia. Which assessment
finding is an indication the patient is experiencing an adverse effect of this drug?
Please choose from one of the following options.
A) Dry Mouth - No
B) Bradycardia – you must check apical pulse, if below 60 you cant give.
C) Urinary Retention - No
D) Parathesia – (tingle, numbness) no
I chose bradycardia because the drug is meant to aid in high blood pressure to help
decrease it. It does this by relaxing the vessels to improve blood flow and decrease
pressure. If a patient has bradycardia while on the drug you should not administer
it because it could continue to lower the pulse. Dry Mouth and urinary retention
are more common effects of anti-cholinergics. Parathesia, just didn’t sound right,
so I didn’t pick it.
A patient is being discharged after the insertion of a permanent pacemaker. Which
statement made by the patient indicates an understanding regarding appropriate
self-care?
A) Every morning I will perform shoulder stretches
B) Each day I will take my pulse and record in my log
C) I’ll have to get rid of my microwave
D) I wont be able to use my electric blanket any more.
It is important the patient is aware of how they are feeling and monitor their pulse.
I couldn’t remember exactly, but I do remember caution with the should after the
,pacemaker has been placed. You don’t have to get rid of a microwave. You could
use the electric blanket, just use with caution because it can dilate the vessels.
SA Node in the right atrium, the pacemaker fires an electrical signal to start the
PQRS. The lead is at the shoulder and you don’t want to disconnect that. Heat
makes the vessels dilate, blood pressure goes down and heart rate goes up.
A patient who has experienced atrial fibrillation for the past 3 days is admitted to
the cardiac care unit. In addition to administering an antidysrhythmia medication,
the healthcare provider should anticipate which of these orders?
A) Initiate a heparin infusion
B) Give Atropine IV push
C) Prepare for immediate cardioversion
D) Prepare the patient for an AV node ablation
When a patient has a fib, you want to give them heparin (I am just not sure if it is
infusion or injection) to keep the quivering blood in the heart from coagulating. I
know you can cardiovert for a fib, I am not sure after how long of trying to fix it
with meds. The other two just didn’t sound right.
A fib the atrium is not working, just quivering. The SA node is not working. The
blood will pool which cause the risk for coagulation and you need to have a blood
thinner on board.
The healthcare provider is caring for a patient with a diagnosis of hypomagnesemia
(1.5-2.5) and a QT interval of 0.500. Which of these, if noted on the cardiac
monitor, is an indication the patient’s condition is worsening?
A) Premature Ventricular Contractions ( Caused by low or high potassium)
B) Narrow QRS
C) An R-R interval of 1 sec
D) A polymorphic ventricular tachycardia (correct) aka torsades.
, A patient with a diagnosis of Wolff-Parkinson-White syndrome is undergoing a
catheter ablation procedure. When caring for the patient after the procedure, which
is the priority intervention?
A) Assist the patient to the bathroom to void
B) Auscultate apical pulse for 1 min every hour
C) Monitor insertion site and distal pulses
D) Assess level of consciousness
I know a catheter ablation has to do with the heart and I feel hearing the apical
pulse for a full min every hour after the procedure is a way to monitor the heart
effectively. A has to do with bladder, D is more neuro, I was not sure about C. I
felt apical pulse was more accurate than distal.
Wolff-Parkinson-White syndrome – affects any age, heart beats really fast and
heart goes crazy electrical problem of the heart. You burn the bad pathways so the
normal can work again. With the hole they could hemorrhage and die. You need
assess for bleeding and check further pulses.
The healthcare provider is teaching a student about the cardiac cycle and how it
relates to the electrocardiogram (EKG). What will the healthcare provider tell the
student about the cardiac events that occur during the waveform contained in the
shaded area of the EKG?
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