A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?
Atrial flutter
Atrial fibrillation
Unstable angina
Premature atrial contractions (PACS)
The Correct Answer is B
A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.
B. Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C. Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D. PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1.5"]
Explanation
To administer the correct dose of desipramine, which is 150 mg, when the available tablet strength is 100 mg, the nurse would need to give 1.5 tablets.
Correct Answer is C
Explanation
A. During chemotherapy, many patients experience nausea, vomiting, and changes in taste or appetite. Spicy and highly-seasoned foods can exacerbate gastrointestinal symptoms and may not be well tolerated. It's generally recommended to encourage bland, easy-to-digest foods to help maintain adequate nutrition and reduce discomfort.
B. Loperamide is not used to prevent nausea; rather, it is an antidiarrheal medication used to treat diarrhea, which can be a side effect of chemotherapy. Nausea prevention is typically managed with antiemetic medications such as ondansetron, metoclopramide, or others prescribed based on the patient's specific needs and chemotherapy regimen.
C. Pain management is an essential aspect of caring for oncology patients, including those receiving chemotherapy. Cancer and its treatment can cause pain directly or indirectly (such as from procedures or complications). Regular and thorough pain assessments allow for timely intervention and improvement in the client's comfort and quality of life.
D. Chemotherapy medications are typically administered through central venous access devices (e.g., central lines, PICC lines) rather than through peripheral veins. This is because chemotherapy drugs can be vesicants (causing tissue damage if they leak out of the vein) or irritants to smaller peripheral veins.
Using a larger gauge peripheral line (e.g., 18 gauge) is not standard practice for administering chemotherapy due to the potential risks and complications associated with peripheral administration.
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