A nurse leaves a coffee shop and sees a man lying on the ground. He is unresponsive and has no pulse and the nurse begins chest compressions. EMS arrives and connects the cardiac monitor displaying this rhythm. Identify the rhythm.
Sinus Rhythm
Ventricular Tachycardia
Ventricular Fibrillation
Sinus Tachycardia
The Correct Answer is C
A. Sinus rhythm is the normal rhythm of the heart with regular P waves, QRS complexes, and T waves. The presence of a sinus rhythm would mean the heart is pumping blood effectively, so the client would not be pulseless. This is inconsistent with the clinical scenario.
B. Ventricular tachycardia (VT) is a fast, regular rhythm originating in the ventricles. VT can lead to pulselessness if not treated, but it has distinct QRS complexes that are wide and regular, unlike the chaotic waveform seen in VF.
C. Ventricular Fibrillation appears as rapid, chaotic electrical activity without identifiable P waves, QRS complexes, or T waves. This rhythm prevents the heart from pumping blood, causing the client to be pulseless and unresponsive. VF is the most common arrhythmia associated with sudden cardiac arrest and requires immediate defibrillation.
D. Sinus tachycardia is a fast heart rate (>100 bpm) with regular rhythm, identifiable P waves, and QRS complexes. This rhythm typically occurs in response to stress, fever, or hypovolemia, and the client would have a pulse, which contradicts the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["900"]
Explanation
Calculate the actual urine output:
Total output - Irrigation solution = Actual urine output
2500 mL (total output) - 1600 mL (irrigation solution) = 900 mL (actual urine output)
Correct Answer is A
Explanation
A. A 19-year-old client with menorrhagia who has been using superabsorbent tampons and has fever with weakness: This is the correct choice. Fever and weakness in the context of menorrhagia suggest a possible infection (e.g., toxic shock syndrome) or severe blood loss, which requires immediate evaluation and intervention.
B. A 35-year-old client with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago: Spotting after IUD insertion is common and does not suggest an immediate threat to the client’s health.
C. A 39-year-old client who is complaining of 4/10 pain after an abdominal hysterectomy: Mild pain after a hysterectomy is expected and not an emergency.
D. A 42-year-old client with secondary amenorrhea who says that her last menstrual cycle was 3 months ago: While secondary amenorrhea requires evaluation, it is not as urgent as a client with signs of possible infection or blood loss.
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