A nurse is monitoring a client's heart rhythm following insertion of a permanent pacemaker. Which of the following images should the nurse expect?
A
B
C
D
The Correct Answer is D
A: This tracing shows occasional premature ventricular contractions (PVCs) with normal QRS complexes, which is not characteristic of a paced rhythm. A permanent pacemaker typically produces consistent pacing spikes preceding the QRS complex.
B: This tracing demonstrates a very rapid, wide-complex rhythm consistent with ventricular tachycardia, not a normal paced rhythm. This is a potentially life-threatening arrhythmia requiring immediate intervention.
C: This tracing shows an irregular rhythm with abnormal QRS morphology, likely atrial fibrillation with conduction abnormalities. It does not show consistent pacemaker spikes before each QRS complex.
D: This tracing displays regular pacing spikes immediately preceding each QRS complex, which is expected in a client with a functioning permanent pacemaker. The spikes indicate the pacemaker is delivering electrical impulses to stimulate ventricular contraction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Wear a high-efficiency particulate air mask: Clients with active tuberculosis require airborne precautions because TB is transmitted through small droplet nuclei that remain suspended in the air. Wearing a high-efficiency particulate air mask (N95 respirator) protects the nurse from inhaling infectious particles during care.
B. Obtain daily sputum specimens: Daily sputum specimens are not required for active TB. Sputum samples are obtained for initial diagnosis and then collected monthly until three consecutive negative results confirm noninfectious status. Collecting them daily would not provide additional benefit and is not part of routine care.
C. Perform chest percussion twice daily: Chest percussion is not a standard intervention for tuberculosis management. TB treatment focuses on airborne isolation, medication adherence, and monitoring response to therapy. Percussion would not improve outcomes or address the primary concerns of infection control and drug therapy.
D. Initiate droplet precautions: Droplet precautions are used for larger respiratory droplets that travel short distances, such as those from influenza or meningitis. TB requires airborne precautions due to its ability to remain suspended in air for prolonged periods.
Correct Answer is C
Explanation
A. Pink-tinged urine: Light pink urine is expected during continuous bladder irrigation after a TURP because of small amounts of bleeding from the surgical site. This finding is not unusual and does not require immediate provider notification.
B. Moderate pain: Some discomfort or cramping is common after TURP due to catheter presence and bladder irrigation. Pain should be managed according to prescribed analgesics but does not necessarily indicate a complication.
C. Decreased urinary output: A sudden decrease in urinary output can indicate catheter obstruction, often caused by blood clots, which is a serious postoperative complication. The nurse should report this immediately to the provider to restore urine flow and prevent bladder distention or further complications.
D. Client urge to void: Feeling the urge to void is expected as the bladder fills during continuous irrigation. This sensation is common and does not indicate a complication that requires provider notification.
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