Based on this strip, which is the correct interpretation of this rhythm?
Accelerated junctional rhythm.
Premature atrial contractions (PAC).
Atrial fibrillation (A-fib).
Wenckebach, Mobitz Type I atrioventricular (AV) block.
The Correct Answer is D
A. Accelerated junctional rhythm: An accelerated junctional rhythm originates in the AV junction (40-100 bpm), typically has absent, inverted, or hidden P waves (before, during, or after QRS), and a regular rhythm. This strip has clear, upright P waves, an irregular rhythm, and a lengthening PR interval.
B. Premature atrial contractions (PAC): PACs are single ectopic beats that occur earlier than expected, originating in the atria. While they involve P waves, they don't show a pattern of progressively lengthening PR intervals or dropped beats in the characteristic Wenckebach pattern.
C. Atrial fibrillation (A-fib): Atrial fibrillation is characterized by irregularly irregular R-R intervals, chaotic atrial activity with no discernible P waves, and a variable ventricular rate. This strip clearly shows discernible P waves.
D. Wenckebach, Mobitz Type I atrioventricular (AV) block: This rhythm is defined by a progressive lengthening of the PR interval until a QRS complex is dropped. The cycle then repeats. This is what is observed in the ECG strip.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Obtain a stat 12-lead ECG and perform a venipuncture to check cardiac enzyme levels: The client's symptoms and ECG changes now indicate an evolving acute myocardial infarction (AMI), especially with new Q waves and ST elevation. Immediate confirmation with another ECG and troponin/CK-MB levels is critical for rapid diagnosis and treatment.
B. Notify the healthcare provider of the client's increased chest pain and call for the defibrillator crash cart: While it's essential to notify the provider, calling for a crash cart is premature unless the client is unstable or experiences life-threatening arrhythmias.
C. Increase the peripheral IV flow rate to 175 mL/hr to prevent hypotension and shock: Rapid IV fluid administration can worsen cardiac workload and lead to pulmonary congestion in clients with evolving MI, particularly if left ventricular function is compromised.
D. Administer prescribed morphine sulfate IV and provide oxygen at 2 L/minute per nasal cannula: Morphine and oxygen are standard interventions for MI, but they should follow diagnostic confirmation. Overuse of oxygen in non-hypoxic patients may cause harm, and morphine may mask symptoms needed for evaluation.
Correct Answer is ["0.5"]
Explanation
Calculation:
Desired dose = 10 mcg.
- Convert the desired dose from micrograms (mcg) to milligrams (mg) to match the available concentration's unit.
Since 1 mg = 1000 mcg,
Desired dose in mg = 10 mcg / 1000 mcg/mg
= 0.01 mg.
Available concentration = 0.02 mg/mL.
- Calculate the volume to administer.
Volume (mL) = Desired dose (mg) / Available concentration (mg/mL)
= 0.01 mg / 0.02 mg/mL
= 0.5 mL.
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