The nurse is assessing the cardiac rhythm of a client who is admitted with coronary artery disease. The nurse notes that the PR interval is 0.24 and the QRS interval is 0.10. Which interpretation would be appropriate for the nurse to make

First degree heart block

Second degree heart block

Bundle branch block

Sinus arrhythmia

Answer and Explanation

The Correct Answer is A

A. First-degree heart block: A prolonged PR interval greater than 0.20 seconds, as seen in this case, indicates first-degree heart block, which is a delay in conduction at the AV node.

B. Second-degree heart block. Second-degree heart block is characterized by some PR intervals being prolonged with occasional dropped beats (non-conducted P waves).

C. Bundle branch block. Bundle branch block causes a wide QRS complex (greater than 0.12 seconds), which is not seen here.

D. Sinus arrhythmia. Sinus arrhythmia involves changes in heart rate due to respiratory cycles, not prolonged PR intervals.

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Correct Answer is D

Explanation

A. Restlessness: This may occur in the pre-active phase of dying but is not specific to the actively dying phase.

B. Decreased appetite: A reduced appetite is common earlier in the dying process, not specific to the actively dying phase.

C. Skin pallor: Skin changes, such as pallor, occur earlier; mottling is more indicative of the actively dying phase.

D. Anuria: Anuria (absence of urine output) is a hallmark sign of multisystem failure and the actively dying phase.

A. Administration of prescribed Atropine B. A prescription for transcutaneous pacing. C. An extra dose of digoxin will be prescribed D. The next dose of digoxin will be held

Correct Answer is D

Explanation

A. Administration of prescribed Atropine. Atropine is typically used for bradycardia related to second-degree heart block Mobitz 2 or complete block, but Mobitz 1 usually resolves on its own and does not require atropine unless symptoms develop.

B. A prescription for transcutaneous pacing. Transcutaneous pacing is typically used for more severe types of heart block, such as Mobitz 2 or third-degree block, not Mobitz 1.

C. An extra dose of digoxin will be prescribed. Giving additional digoxin would be contraindicated due to its effects on AV conduction.

D. The next dose of digoxin will be held: Second-degree heart block Mobitz 1 (also known as Wenckebach) can be worsened by digoxin, which has a vagomimetic effect that can slow conduction through the AV node. Therefore, the next dose of digoxin should be held to avoid further exacerbating the block.

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The nurse is assessing the cardiac rhythm of a client who is admitted with coronary artery disease. The nurse notes that the PR interval is 0.24 and the QRS interval is 0.10. Which interpretation would be appropriate for the nurse to make

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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