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 D

Explanation

A. Pyridostigmine is primarily used in the treatment of myasthenia gravis, a different autoimmune neuromuscular disorder characterized by weakness of voluntary muscles. It works by inhibiting the

enzyme acetylcholinesterase, which increases the levels of acetylcholine at neuromuscular junctions, thereby improving muscle strength. It is not used for treating multiple sclerosis.
B. Levodopa-carbidopa is commonly used to treat Parkinson’s disease. Levodopa is converted to dopamine in the brain, and carbidopa prevents levodopa from being converted into dopamine before it reaches the brain. This combination helps manage the motor symptoms of Parkinson’s disease. It is not used for multiple sclerosis.
C. Riluzole is used primarily for the treatment of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons. It works by reducing the release of glutamate, a neurotransmitter that can be toxic to nerve cells. Riluzole is not used for multiple sclerosis.
D. Interferon-beta is a disease-modifying therapy used in the treatment of multiple sclerosis. It works by modulating the immune system to reduce the frequency and severity of MS relapses. Interferon-beta can help slow the progression of disability and reduce the number of new lesions seen on MRI scans.

A. Spinach B. Anchovies C. Organ meats D. Milk

Correct Answer is A

Explanation

A. Spinach is known to be high in oxalates. Oxalates are compounds that can bind with calcium in the urine, forming calcium oxalate stones, which are the most common type of kidney stones. For clients with a history of kidney stones related to high oxalate intake, it is crucial to limit or avoid high-oxalate foods such as spinach to reduce the risk of further stone formation.
B. Anchovies are not particularly high in oxalates. They are more commonly associated with other nutritional considerations, such as being a good source of omega-3 fatty acids and protein. While anchovies are not a significant source of oxalates, they are not a primary concern for those needing to manage oxalate intake.
C. Organ meats, such as liver and kidneys, are not known for high oxalate content. They are high in other nutrients and substances but do not significantly contribute to oxalate levels in the urine. Therefore, avoiding organ meats is not typically necessary for managing oxalate levels.
D. Milk is not high in oxalates. In fact, dairy products are a good source of calcium, which can help bind oxalates in the gut and reduce their absorption. For individuals managing oxalate levels, increasing calcium intake from dairy products can be beneficial. Milk and other dairy products are generally not restricted in a diet aimed at reducing oxalate intake.

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Naxlex Comprehensive Predictor Exams

Which medication is commonly used in the treatment of multiple sclerosis?

Correct Answer is D

Explanation

A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive oxalate intake is the underlying cause. Which of the following high-oxalate foods should the nurse instruct the client to avoid?

Correct Answer is A

Explanation

A nurse is providing education to a group of older adults about the signs and symptoms of a myocardial infarction. Which of the following is not a sign of a myocardial infarction?

A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

Which of the following clients is at risk for sensorineural hearing loss?

Which nursing intervention is the most appropriate to implement for a client who experiencing weight loss due to nausea caused by chemotherapy?

A nurse is caring for a 43-year-old female client who reports abdominal pain. Exhibits For each potential provider's order, click to specify if the potential order is anticipated or contraindicated for this client.

The nurse is collecting a stool specimen from a client. What stool characteristic indicates to the nurse that the client may have an upper gastrointestinal (GI) bleed?

A nurse in an emergency department (ED) is admitting a client. Exhibits Select the 3 orders that the nurse should expect for this client.