In the change of shift report, you are told that your client is in a second-degree type 1 AV heart block. You anticipate that the cardiac rhythm strip will reveal which of the following?
There will be one QRS complex for each P wave, but the PR interval will be prolonged.
There will be more P waves than QRS complexes, and the PR interval gets progressively longer.
There are more P waves than QRS complexes, and the PR interval stays the same.
There are more QRS complexes than P waves, and the PR interval gets progressively longer.
The Correct Answer is B
A. This describes first-degree AV block, where every P wave is conducted to the ventricles, but the PR interval is prolonged.
B. Second-degree type 1 AV block (Wenckebach/Mobitz I) is characterized by a progressive lengthening of the PR interval until a QRS complex is dropped, resulting in more P waves than QRS complexes. This pattern then repeats cyclically.
C. This describes second-degree type 2 AV block (Mobitz II), where some P waves are not conducted but the PR interval of conducted beats remains constant.
D. There are never more QRS complexes than P waves in AV block; this pattern is inconsistent with the physiology of AV conduction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Activity may be restricted initially to prevent lead displacement; early ambulation is not the primary focus immediately after implantation.
B. A quiet environment is not directly related to pacemaker function or post-procedure safety.
C. Continuous assessment of heart rate, rhythm, and vital signs is critical to ensure the pacemaker is functioning properly and to detect complications such as arrhythmias or device malfunction.
D. Routine anticoagulants are not indicated solely for pacemaker implantation unless there is another underlying condition requiring them.
Correct Answer is D
Explanation
A. Third-degree AV block is a bradyarrhythmia and typically has a wide QRS due to ventricular escape rhythm.
B. Ventricular tachycardia originates in the ventricles, producing a wide QRS complex.
C. Ventricular fibrillation is characterized by chaotic ventricular activity with no discernible QRS complexes.
D. Supraventricular tachycardia originates above the ventricles (atria or AV node) and produces a narrow QRS complex, making it the classic example of narrow complex tachycardia.
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