A client in an urgent care clinic is reports having heart palpitations, and occasional shortness of breath. A 12-lead electrocardiogram (ECG) shows regular P- waves in a sawtooth formation at a rate of 260 beats per minute, and a regular ventricular rate of 82 beats per minute. The nurse should understand that this ECG finding represents which of the following conditions?

Atrial fibrillation

Atrial flutter

Unstable angina

Premature atrial contractions

Answer and Explanation

The Correct Answer is B

A.   Atrial fibrillation is characterized by irregularly irregular rhythms with no distinct P-waves. Instead, it has a chaotic baseline with fibrillatory waves. The ventricular response can be irregular and variable. The description provided (regular P-waves in a sawtooth formation) does not match the typical appearance of atrial fibrillation, which lacks regular P-waves and has an irregular rhythm.
B.   Atrial flutter is characterized by regular, sawtooth-shaped P-waves known as "F-waves" or "flutter waves." The classic pattern is referred to as "F-waves" with a "sawtooth" appearance, often seen in the inferior leads (II, III, aVF). The atrial rate is typically between 240 to 340 beats per minute, which fits the rate of 260 beats per minute in the description. The ventricular rate can be regular or irregular, depending on the degree of AV node conduction. A

C.   Unstable angina is a clinical diagnosis of chest pain due to myocardial ischemia. It is not associated with specific ECG findings related to the P-wave morphology or rate. The ECG findings described do not correspond to unstable angina, which would typically present with ST-segment changes or other signs of myocardial ischemia rather than a specific P-wave pattern.
D.   Premature atrial contractions (PACs) are early beats originating from the atria that interrupt the normal rhythm. They usually present as a single early beat with a different morphology of the P-wave compared to the sinus P-waves, but do not result in a regular sawtooth pattern or a sustained rhythm at high rates like the one described.

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Correct Answer is ["0.4"]

Explanation

Volume to administer = (Desired Dose) / (Concentration of available medication). The desired dose is 2,000 units, and the concentration available is 5,000 units/mL. Using the formula, you get 2,000 units / 5,000 units/mL = 0.4 mL.
Therefore, the nurse should administer 0.4 mL of heparin injection to deliver a dose of 2,000 units.

A. Women with lupus should ensure that they get plenty of sun each day while they are pregnant. B. Women with lupus should not become pregnant, because the disease poses too many risks. C. Women with lupus should have frequent prenatal visits and close monitoring of lupus symptoms during pregnancy. D. Women with lupus should avoid all medications during pregnancy to prevent harm to the baby.

Correct Answer is C

Explanation

A. Women with lupus should ensure that they get plenty of sun each day while they are pregnant. Exposure to sunlight can exacerbate lupus symptoms, especially in women with lupus photosensitivity. It's important for women with lupus to avoid excessive sun exposure and wear protective clothing and sunscreen.

B. Women with lupus should not become pregnant, because the disease poses too many risks. While pregnancy can pose additional risks for women with lupus, it is not always contraindicated. With proper management, many women with lupus can have healthy pregnancies.
C. It is important for women with lupus to receive frequent prenatal care and close monitoring of their lupus symptoms throughout pregnancy. This includes regular check-ups with a rheumatologist and obstetrician, monitoring of blood pressure, kidney function, and lupus activity, as well as screening for fetal development.
D. Women with lupus should avoid all medications during pregnancy to prevent harm to the baby. This is not always the case. Some medications may be necessary to manage lupus symptoms during pregnancy, and the benefits often outweigh the risks. It's important to discuss medication options with healthcare providers to determine the best course of action.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer heparin 2,000 units by IV bolus. Available is heparin injection 5,000 units/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.4"]

Explanation

A female client with systemic lupus erythematosus (SLE) asks the nurse about pregnancy and lupus. Which information should the nurse include when educating the client?

Correct Answer is C

Explanation

A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?

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