A nurse is assessing a client's ECG strip and notes an irregular heart rate of 98/min with no clear P waves. Which of the following cardiac dysrhythmias should the nurse document?

First-degree heart block

Atrial fibrillation

Complete heart block

Ventricular tachycardia

Answer and Explanation

The Correct Answer is B

Rationale:
A. First-degree heart block: This rhythm shows a prolonged PR interval but maintains regular P waves before every QRS complex and a consistent rhythm. The presence of P waves and regularity rule out this option.

B. Atrial fibrillation: Atrial fibrillation is characterized by an irregularly irregular rhythm and absent or indistinct P waves due to disorganized atrial electrical activity. A heart rate of 98/min with no clear P waves fits the criteria for this dysrhythmia.

C. Complete heart block: Complete (third-degree) heart block features a complete dissociation between atrial and ventricular activity, with P waves and QRS complexes occurring independently. It typically presents with a bradycardic rhythm, not near 98/min.

D. Ventricular tachycardia: Ventricular tachycardia presents with a rapid, regular rhythm and wide QRS complexes. It usually lacks P waves but is typically much faster than 98/min, often ranging from 140 to 200 beats/min.

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Correct Answer is ["B","C","D"]

Explanation

Rationale:
A. Ferrous sulfate: Ferrous sulfate is an iron supplement and does not directly interact with warfarin's anticoagulant effect. While some mild interactions are possible, it is not generally contraindicated unless specifically advised due to individual clinical conditions.

B. Aspirin: Aspirin has antiplatelet effects and can increase the risk of bleeding when taken with warfarin. The combination enhances anticoagulation and significantly raises the chance of gastrointestinal or systemic bleeding.

C. Naproxen: Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can interfere with platelet function and irritate the gastrointestinal lining, increasing the risk of bleeding when combined with warfarin.

D. Echinacea: Echinacea may interfere with liver enzyme activity and affect the metabolism of warfarin, potentially altering its effectiveness. Herbal supplements can cause unpredictable interactions and should generally be avoided while on warfarin.

E. Dextromethorphan: Dextromethorphan is a common cough suppressant and does not have significant interactions with warfarin. It is generally considered safe for occasional use in clients taking anticoagulants.

A. Give each screw a quarter turn daily using the wrench provided. B. Apply powder liberally under the chest portion of the halo fixator device. C. Avoid the use of straws when drinking liquids. D. Place a small pillow under the head while lying supine.

Correct Answer is D

Explanation

Rationale:
A. Give each screw a quarter turn daily using the wrench provided: Clients should never adjust or tighten the halo device screws themselves. Only trained medical professionals should handle adjustments to avoid misalignment or injury to the cervical spine.

B. Apply powder liberally under the chest portion of the halo fixator device: Powder can cake and irritate the skin or lead to moisture buildup, increasing the risk of skin breakdown or infection. The skin under the vest should be kept clean and dry, not powdered.

C. Avoid the use of straws when drinking liquids: Clients can safely use straws to drink fluids while wearing a halo device. There is no contraindication for using a straw, and it may actually make drinking easier.

D. Place a small pillow under the head while lying supine: Using a small pillow supports neck alignment and promotes comfort without compromising the stability of the halo device. This is an appropriate and recommended practice during rest.

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A nurse is assessing a client's ECG strip and notes an irregular heart rate of 98/min with no clear P waves. Which of the following cardiac dysrhythmias should the nurse document?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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