A nurse is analyzing a client's electrocardiogram (ECG) strip and identifies the following information:

Heart rate: 92/min

Rhythm: Irregular

P wave: Unable to identify

PR interval: Unable to measure

QRS duration: O. 1 0 seconds
Based upon this information, the nurse should interpret the client's rhythm as indicating which of the following?

Atrial fibrillation

Sinus bradycardia

Supraventricular tachycardia

First-degree heart block

Answer and Explanation

The Correct Answer is A

A. Atrial fibrillation: Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of identifiable P waves, and irregular ventricular response. The heart rate in atrial fibrillation can be variable, and the absence of identifiable P waves indicates disorganized atrial electrical activity.

B. Sinus bradycardia: Sinus bradycardia is characterized by a regular rhythm with a heart rate less than 60 beats per minute (bpm) and normal P waves preceding each QRS complex. In sinus bradycardia, the PR interval and QRS duration are typically within normal limits.

C. Supraventricular tachycardia: Supraventricular tachycardia (SVT) is characterized by a regular rhythm with a heart rate greater than 100 bpm. SVT typically presents with narrow QRS complexes and may or may not have discernible P waves.

D. First-degree heart block: First-degree heart block is characterized by a prolonged PR interval (>0.20 seconds) but maintains a regular rhythm with normal QRS duration. In first-degree heart block, P waves are typically identifiable, and the rhythm is not irregular.

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Correct Answer is A

Explanation

A. The client whose mother and uncle were diagnosed with this same condition: Hypertrophic cardiomyopathy (HCM) often has a genetic component, with a familial predisposition observed in many cases. Individuals with a family history of HCM, especially in first-degree relatives such as parents or siblings, are at higher risk of developing the condition due to genetic factors.

B. The client who is recovering from a recent illness that caused vomiting and diarrhea: Acute illnesses such as vomiting and diarrhea can lead to dehydration, electrolyte imbalances, and transient changes in cardiac function. While dehydration and electrolyte imbalances may exacerbate symptoms in individuals with existing cardiac conditions, they are not primary risk factors for developing hypertrophic cardiomyopathy (HCM).

C. The client who is out of work and has been experiencing increased stress: Chronic stress and psychosocial factors may contribute to the progression of cardiovascular disease in general, but they are not specific risk factors for developing hypertrophic cardiomyopathy (HCM).

D. The client who uses oxygen at night to treat obstructive sleep apnea: While obstructive sleep apnea is associated with cardiovascular complications, including hypertrophic cardiomyopathy (HCM), the use of oxygen therapy at night to treat sleep apnea does not directly increase the risk of developing HCM. However, untreated obstructive sleep apnea may lead to chronic hypoxia and other cardiac issues over time.

A. Elevated erythrocyte sedimentation rate (ESR) B. Elevated thyroid-stimulating hormone (TSH) C. Elevated brain natriuretic peptide (BNP) D. Elevated C-reactive protein (CRP)

Correct Answer is B

Explanation

A. Elevated erythrocyte sedimentation rate (ESR): Elevated ESR indicates inflammation in the body and is not typically associated with the cause of atrial fibrillation.

B. Elevated thyroid-stimulating hormone (TSH): This is the correct answer. A common cause of atrial fibrillation is hyperthyroidism, which is characterized by an overactive thyroid gland and often presents with elevated TSH levels. Thyroid hormones play a significant role in regulating heart rate and rhythm. Excess thyroid hormone can lead to increased heart rate and irregular heart rhythms, including atrial fibrillation.

C. Elevated brain natriuretic peptide (BNP): Elevated BNP levels are associated with heart failure and may indicate cardiac stress or dysfunction. While heart failure can predispose individuals to atrial fibrillation, elevated BNP levels themselves are not a direct cause of atrial fibrillation.

D. Elevated C-reactive protein (CRP): Elevated CRP levels indicate inflammation in the body and are associated with various cardiovascular diseases. While inflammation can contribute to atrial fibrillation, elevated CRP levels alone are not a direct cause of atrial fibrillation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a group of clients about risk factors for developing hypertrophic cardiomyopathy (HCM). Which of the following clients should the nurse understand is most at risk for developing HCM?

Correct Answer is A

Explanation

A nurse is reviewing laboratory results for a client who has atrial fibrillation. Which of the following blood test results should the nurse understand can be a possible cause of atrial fibrillation?

Correct Answer is B

Explanation

A nurse is assessing a client who has peripheral artery disease. Which of the following findings should the nurse recognize as requiring immediate intervention?

A nurse is preparing a poster about chronic traumatic encephalopathy (CTE) for a local community health fair. Which of the following activities should the nurse include on the poster as increasing the risk for CTE?

A nurse is teaching a client who has pericarditis. Which of the following statements should the nurse include in the client teaching to explain the cause of pericarditis?

Which of the following are risk factors for abdominal aortic aneurysm (AAA)? (Select all that apply.)

A nurse is teaching a client who has dilated cardiomyopathy (DCM) about this condition. Which of the following statements by the nurse should be included in the teaching?

A nurse is educating the family of a client who has Alzheimer's disease. The nurse should be sure to communicate that which of the following behavioral manifestations can occur in clients with Alzheimer’s disease? (Select All that Apply.)

A nurse is collecting data from a client related to changes in vision. Which of the following statements indicates that the client might be developing a cataract?

A nurse is teaching a client who has restrictive cardiomyopathy (RCM). Which of the following statements should the nurse include in the client teaching to explain the cause of RCM?