During the refractory stage of shock in hypovolemia, which of the following responses accurately describes the physiological changes that occur?

Increased cardiac output and improved tissue perfusion

Restored fluid balance and resolution of hypovolemia

Worsening organ dysfunction and failure

Decreased heart rate and improved blood pressure

Answer and Explanation

The Correct Answer is C

A. In the refractory stage, cardiac output is decreased and tissue perfusion is severely impaired, not improved.
B. Fluid balance is not restored during the refractory stage; instead, hypovolemia worsens.
C. The refractory stage is characterized by irreversible damage with worsening organ dysfunction and failure despite interventions.
D. Heart rate usually increases initially, and blood pressure typically decreases; decreased heart rate and improved blood pressure are not features of this stage.

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Correct Answer is B

Explanation

A. Ventricular tachycardia presents with wide QRS complexes and a fast ventricular rate, but not sawtooth P waves.
B. Atrial flutter is characterized by a rapid atrial rate (typically around 250–350 beats/min) and "sawtooth" flutter waves on the ECG. The ventricular response is often regular, as seen in this client with a ventricular rate of 82 beats/min.
C. Atrial fibrillation presents with an irregularly irregular rhythm and absent P waves, replaced by fibrillatory waves — not the sawtooth pattern described here.
D. Ventricular fibrillation shows chaotic, irregular, and disorganized electrical activity with no identifiable P waves, QRS complexes, or T waves, and would not present as a stable rhythm with a ventricular rate of 82 bpm.

A. Sinus bradycardia B. First degree heart block C. Normal sinus rhythm D. Sick sinus syndrome

Correct Answer is C

Explanation

A. Sinus bradycardia is characterized by a heart rate less than 60 beats/min, but in this case the rate is exactly 60, which is normal lower limit.
B. First degree heart block involves a prolonged PR interval (>0.20 seconds); here, the PR interval is normal (0.16 seconds).
C. Normal sinus rhythm has regular P waves and QRS complexes, a normal PR interval (0.12–0.20 seconds), and a heart rate between 60–100 beats/min.
D. Sick sinus syndrome is characterized by irregular rhythms and abnormal sinus node function, which is not indicated here.

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During the refractory stage of shock in hypovolemia, which of the following responses accurately describes the physiological changes that occur?

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Naxlex Comprehensive Predictor Exams

The nurse is monitoring a client in the post-anesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm?

Correct Answer is B

Explanation

A nurse is assessing an ECG rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second. The overall heart rate is 60 beats/min. The nurse assesses the cardiac rhythm as:

Correct Answer is C

Explanation

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