A nurse is monitoring a client who is on telemetry.
Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?

The QRS duration is 0.30 seconds.

The T wave is in the inverted position.

The P-R interval measures 0.32 seconds.

The P wave falls before the QRS complex.

Answer and Explanation

The Correct Answer is D

Choice A rationale

A QRS duration of 0.30 seconds is abnormally long. The normal QRS duration is 0.06 to 0.12 seconds, indicating this is not normal sinus rhythm.

Choice B rationale

An inverted T wave is not a characteristic of normal sinus rhythm. It may indicate ischemia or other cardiac abnormalities.

Choice C rationale

A P-R interval of 0.32 seconds is prolonged. The normal P-R interval is 0.12 to 0.20 seconds, thus indicating an abnormal rhythm.

Choice D rationale

The P wave falling before the QRS complex is a key characteristic of normal sinus rhythm, representing the orderly conduction of electrical impulses from atria to ventricles. .

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Correct Answer is C

Explanation

Choice A rationale

Increased PAWP indicates left-sided heart failure, as it measures pressure in the left atrium and left ventricle. Right-sided heart failure typically presents with systemic venous congestion rather than pulmonary congestion. Normal PAWP: 6-12 mmHg.

Choice B rationale

Decreased specific gravity is not a typical finding in right-sided heart failure. Specific gravity measures urine concentration and can vary based on fluid intake and kidney function. Normal range: 1.005-1.030.

Choice C rationale

Ascending dependent edema results from increased venous pressure and fluid retention in the lower extremities, common in right-sided heart failure due to impaired venous return and fluid overload.

Choice D rationale

Decreased BNP is not characteristic of heart failure. BNP levels increase in response to ventricular volume expansion and pressure overload. Elevated BNP aids in diagnosing heart failure. Normal BNP: <100 pg/mL. .

A. A headache is an expected adverse effect of the medication. B. A headache indicates tolerance to the medication. C. A headache is likely due to anxiety about the chest pain. D. A headache is an indication of an allergy to the medication.

Correct Answer is A

Explanation

Choice A rationale

Nitroglycerin causes vasodilation, leading to headaches as a common adverse effect. These headaches are due to the increased blood flow and dilation of cerebral blood vessels.

Choice B rationale

Headaches do not indicate tolerance to nitroglycerin. Tolerance typically presents with a diminished therapeutic effect, not adverse effects like headaches.

Choice C rationale

Anxiety-induced headaches are unlikely since nitroglycerin-induced headaches are a physiological response to vasodilation, not psychological factors.

Choice D rationale

An allergic reaction to nitroglycerin would present with symptoms like rash or itching, not headaches. Headaches are a known and expected adverse effect.

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A nurse is monitoring a client who is on telemetry.
Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?