A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?

Sinus bradycardia

Sinus tachycardia

Atrial fibrillation

First-degree AV block

Answer and Explanation

The Correct Answer is C

Choice A Reason: This is incorrect. Sinus bradycardia is a slow and regular heart rate that originates from the sinus node. It does not cause irregular palpitations, fatigue, or dizziness, unless the heart rate is very low or the client has underlying cardiac disease.

Choice B reason: This is incorrect. Sinus tachycardia is a fast and regular heart rate that originates from the sinus node. It may cause fatigue or dizziness, but not irregular palpitations or pulse deficit.

Choice C Reason: This is correct. Atrial fibrillation is a fast and irregular heart rate that originates from multiple foci in the atria. It causes irregular palpitations, fatigue, dizziness, and pulse deficit due to ineﬀective atrial contractions and variable ventricular response.

Choice D Reason: This is incorrect. First-degree AV block is a delay in the conduction of impulses from the atria to the ventricles. It does not aﬀect the heart rate or rhythm, and does not cause any symptoms.

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Correct Answer is B

Explanation

Choice A Reason: This is incorrect because a decreased level of consciousness is a late sign of shock, not an early one. Decreased level of consciousness indicates that the brain is not receiving enough oxygen and blood ﬂow, which can lead to irreversible damage and death.

Choice B Reason: This is correct because increased respiratory rate is an early sign of shock, indicating hypoxia. This finding indicates that the client is experiencing hypoxia, which is a lack of oxygen in the tissues and organs. Hypoxia is a common and early sign of shock, which is a condition where the body's vital organs do not receive enough blood

ﬂow and oxygen due to low blood pressure, low cardiac output, or low blood volume. The client's respiratory rate increases as a compensatory mechanism to increase oxygen intake and delivery.

Choice C Reason: This is incorrect because hypotension is a late sign of shock, not an early one. Hypotension indicates that the blood pressure is too low to maintain adequate perfusion and oxygenation to the vital organs.

Choice D Reason: This is incorrect because anuria is a late sign of shock, not an early one. Anuria indicates that the kidneys are not receiving enough blood ﬂow and oxygen, which can result in acute kidney injury or failure.

A. Decreased specific gravity B. Decreased brain natriuretic peptide (BNP) C. Increased pulmonary artery wedge pressure (PAWP) D. Elevated central venous pressure (CVP)

Correct Answer is D

Explanation

Choice A: Decreased specific gravity is not a finding of right-sided heart failure. Specific gravity is a measure of urine concentration, which can be aﬀected by ﬂuid intake, dehydration, kidney function, and diuretic use. Right-sided heart failure does not directly aﬀect urine concentration, but it can cause ﬂuid retention and edema in the body.

Choice B: Decreased brain natriuretic peptide (BNP) is not a finding of right-sided heart failure. BNP is a hormone that is released by the heart when it is stretched or overloaded. BNP helps to lower blood pressure and reduce ﬂuid volume by increasing urine output and dilating blood vessels. BNP levels are elevated in both left-sided and right- sided heart failure, as the heart is under increased pressure and volume.

Choice C: Increased pulmonary artery wedge pressure (PAWP) is not a finding of right-sided heart failure. PAWP is a measure of the pressure in the left atrium, which reﬂects the pressure in the pulmonary capillaries. PAWP is elevated in left-sided heart failure, as the blood backs up in the lungs due to impaired left ventricular function. PAWP is normal or low in right-sided heart failure, as the blood backs up in the systemic circulation due to impaired right ventricular function.

Choice D: Elevated central venous pressure (CVP) is a finding of right-sided heart failure. CVP is a measure of the pressure in the right atrium, which reﬂects the pressure in the systemic venous system. CVP is elevated in right-sided heart failure, as the blood backs up in the body due to impaired right ventricular function. CVP can cause jugular venous distension, hepatomegaly, splenomegaly, ascites, and peripheral edema.

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A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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