A nurse is reviewing a client's cardiac monitor for dysrhythmias. Which of the following findings should the nurse identify as an indication for the placement of a permanent pacemaker?
Vasovagal bradycardia without syncope
Complete AV block with rates slower than 40/min
Sinus tachycardia with rates faster than 80/min
Asymptomatic second-degree AV block
The Correct Answer is B
A complete AV block (also called third-degree AV block) is a type of heart block in which there is no electrical communication between the atria and ventricles. This means that the atria and ventricles beat independently of each other, resulting in a slow and irregular pulse. A complete AV block can cause symptoms such as dizziness, fainting, chest pain, shortness of breath, and heart failure.
A permanent pacemaker is a device that sends electrical impulses to the heart to regulate its rhythm and prevent bradycardia (slow heart rate). A permanent pacemaker is indicated for clients with complete AV block and rates slower than 40/min or symptomatic bradycardia.
The other options are not indications for a permanent pacemaker. Vasovagal bradycardia is a temporary drop in heart rate and blood pressure caused by a stimulus that triggers the vagus nerve, such as pain, stress, or straining.
It usually resolves on its own or with simple measures, such as lying down or elevating the legs. Sinus tachycardia is a normal increase in heart rate in response to physical or emotional stress, such as exercise, fever, or anxiety. It usually does not require treatment unless it is caused by an underlying condition or causes symptoms.
Asymptomatic second-degree AV block is a type of heart block in which some of the electrical impulses from the atria are blocked from reaching the ventricles. It may not cause any symptoms or affect the overall heart rate. It may be benign or transient, or it may progress to a more serious type of heart block. It may require monitoring or medication, but not a permanent pacemaker unless it causes symptomatic bradycardia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
An acute asthma attack is a sudden worsening of asthma symptoms, such as coughing, wheezing, tightness in the chest, and difficulty breathing. These symptoms happen because the airways in the lungs become narrow, irritated, swollen, and produce excess mucus.
An asthma attack can be triggered by various factors, such as allergic reactions, respiratory infections, tobacco smoke, cold air, and exercise. These triggers cause the immune system to react and release chemicals that cause inflammation and constriction of the airways.
Based on this information, the best answer to the question is a. Inability to exhale retained carbon dioxide. This is because during an asthma attack, the narrowed airways make it harder to exhale the air from the lungs, which leads to a buildup of carbon dioxide in the blood. This can worsen the symptoms and cause acidosis, a condition where the blood becomes too acidic.
The other options are not correct because:
b. Acute loss of alveolar elasticity is not a cause of asthma attacks, but a consequence of chronic obstructive pulmonary disease (COPD), a different lung condition that involves damage to the alveoli, the tiny air sacs in the lungs.
c. Decreased responsiveness of airways to allergens is not a cause of asthma attacks, but a goal of asthma treatment. Asthma medications aim to reduce the sensitivity and inflammation of the airways to prevent or reduce the frequency and severity of asthma attacks.
d. Suppressed bronchiolar inflammatory response is not a cause of asthma attacks, but a potential side effect of some asthma medications, such as corticosteroids. These drugs can suppress the immune system and increase the risk of infections in the airways.
Correct Answer is D
Explanation
Positive end-expiratory pressure (PEEP) is a mode of mechanical ventilation that maintains a positive pressure in the airways at the end of expiration, preventing alveolar collapse and improving oxygenation. PEEP does not affect tidal volume, inspiratory pressure, or ventilation rate, which are determined by other ventilator settings.
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