A nurse is reviewing the sequence of the cardiac cycle. The nurse recognizes that the electrical stimulus of the cardiac cycle follows which sequence?

AV node-• SA node-• bundle of His -• Erb's Point

Bundle of His -• AV node -• SA node -• Erb's Point

AV node -• SA node -• bundle of His -• bundle branches

SA node -• AV node -• bundle of His -• bundle branches

Answer and Explanation

The Correct Answer is D

A) AV node → SA node → bundle of His → Erb's Point:
This sequence is incorrect because the electrical impulse of the heart starts at the SA (sinoatrial) node, not the AV (atrioventricular) node. The SA node is the natural pacemaker of the heart, initiating the electrical signal. The correct order of conduction is SA node → AV node → bundle of His → bundle branches, and finally, the Purkinje fibers. Erb's Point is an anatomical reference point for auscultation, not part of the electrical conduction pathway.

B) Bundle of His → AV node → SA node → Erb's Point:
This sequence is also incorrect. The electrical impulse originates at the SA node, not the bundle of His. The SA node stimulates the AV node, which in turn sends the signal to the bundle of His and then to the bundle branches. This pathway is essential for coordinating the contraction of the heart muscle, starting from the atria and moving to the ventricles.

C) AV node → SA node → bundle of His → bundle branches:
This sequence is reversed and incorrect. The impulse starts at the SA node, not the AV node. The SA node fires first, sending the electrical signal to the AV node, and then the signal travels down the bundle of His, into the left and right bundle branches, and finally to the Purkinje fibers.

D) SA node → AV node → bundle of His → bundle branches:
This is the correct sequence of the electrical conduction pathway of the heart. The electrical impulse originates at the SA node (the heart's natural pacemaker), then travels to the AV node, where it is delayed to allow the atria to contract and fill the ventricles. From there, the impulse moves down the bundle of His, which splits into the left and right bundle branches, leading to the Purkinje fibers that transmit the impulse throughout the ventricles, causing them to contract. This sequence ensures proper coordination and timing of the heart's contractions.

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Correct Answer is C

Explanation

A) The best time to perform BSE is immediately prior to the menstrual cycle:
Performing a breast self-examination (BSE) immediately prior to the menstrual cycle is not ideal because hormonal changes leading up to menstruation can cause the breasts to become swollen, tender, and lumpy. These changes could make it difficult to detect subtle lumps or changes in the breast tissue. For the most accurate assessment, it's recommended that women avoid performing BSE during the premenstrual phase when the breast tissue is most likely to be affected by hormonal fluctuations.

B) If pregnancy is suspected, BSE should not be performed until post-delivery:
This statement is incorrect. There is no contraindication to performing a breast self-examination during pregnancy, and it is important for pregnant women to continue self-monitoring for any changes in breast tissue. In fact, BSE should be performed regularly during pregnancy, as the breast tissue can undergo changes due to hormonal shifts, and early detection of any abnormalities is key to successful management.

C) The best time to perform BSE is 4 to 7 days after the first day of the menstrual period:
This is the correct recommendation. The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period because the breasts are least likely to be swollen or tender during this time. Hormonal levels are more stable at this point in the menstrual cycle, and any lumps or changes in the tissue are more likely to be noticeable. Performing BSE during this time increases the likelihood of detecting potential abnormalities.

D) The woman with diagnosed fibrocystic breast tissue should not rely on BSE:
While it is true that women with fibrocystic breast changes may experience lumpy, tender tissue, they should still perform BSE regularly. Fibrocystic tissue can sometimes make it more difficult to distinguish between normal and abnormal changes, but BSE remains an important tool for detecting significant changes, such as new lumps or changes in size, shape, or consistency. Women with fibrocystic breast tissue should be taught to perform BSE regularly and to report any unusual changes to their healthcare provider. Relying solely on BSE for breast cancer detection is not recommended, but it is an essential part of breast health awareness.

A. Atelectatic crackles that do not have a pathologic cause B. Fine crackles that may be a sign of impending pneumonia C. Vesicular breath sounds D. Fine wheezes

Correct Answer is A

Explanation

A) Atelectatic crackles that do not have a pathologic cause:
Atelectatic crackles are short, popping, crackling sounds heard during auscultation, typically occurring at the end of inspiration. These crackles are often heard in the bases of the lungs, particularly when the client is in a supine position, and are not associated with any pathological condition. Atelectatic crackles are a normal finding, especially in a sleeping or newly awakened client, as they result from the temporary collapse of small airways that quickly re-expand. Since they disappear after a few breaths and are not indicative of disease, they should be documented as atelectatic crackles without a pathological cause.

B) Fine crackles that may be a sign of impending pneumonia:
Fine crackles are high-pitched, popping sounds that are often heard during inspiration, especially at the lung bases. They are commonly associated with conditions like pneumonia, heart failure, or pulmonary fibrosis. However, in this case, the crackles heard stopped after a few breaths, which is characteristic of atelectatic crackles rather than fine crackles associated with pathological conditions. Fine crackles that last and occur consistently may suggest pathology, but in this scenario, the transient nature of the sounds points to atelectatic crackles, not pneumonia.

C) Vesicular breath sounds:
Vesicular breath sounds are normal lung sounds heard over the peripheral lung fields, characterized by a soft, low-pitched sound during inspiration, with a shorter expiration. These sounds are different from crackles, which are brief, popping sounds. Vesicular breath sounds do not refer to abnormal or adventitious sounds, such as the crackles heard in this client. Therefore, the nurse should not document the breath sounds as vesicular.

D) Fine wheezes:
Wheezes are continuous musical sounds produced by the narrowing of the airways, typically heard during exhalation. They are usually caused by conditions like asthma, chronic obstructive pulmonary disease (COPD), or bronchitis. The crackling sounds described in the question are not wheezes, as they are short, popping sounds rather than musical, continuous sounds. The transient nature of the sounds makes them more consistent with atelectatic crackles, not wheezes.

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A nurse is reviewing the sequence of the cardiac cycle. The nurse recognizes that the electrical stimulus of the cardiac cycle follows which sequence?

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Naxlex Comprehensive Predictor Exams

A nurse is conducting a class on Breast Self-Examination (BSE) for women of childbearing age. The nurse should include which of these statements that indicates the proper BSE technique?

Correct Answer is C

Explanation

A nurse is auscultating the lungs of a sleeping client and hears short, popping, crackling breath sounds that stop after a few breaths. How should the nurse document these breath sounds in the client's medical record?

Correct Answer is A

Explanation

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A nurse is reviewing the sequence of the cardiac cycle. The nurse recognizes that the electrical stimulus of the cardiac cycle follows which sequence?

A nurse is performing a voice test to assess a client's hearing. Which of these actions should the nurse perform?

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