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. A client with left-sided heart failure on oxygen via nasal cannula B. A client with syncope who is being discharged today C. A client scheduled for a cardiac ultrasound this morning D. A client with controlled atrial fibrillation with a heart rate of 82

Correct Answer is A

Explanation

A. A client with left-sided heart failure on oxygen via nasal cannula: This client is at risk for respiratory distress due to pulmonary congestion. Immediate assessment is needed to ensure oxygenation and manage potential deterioration.

B. A client with syncope who is being discharged today: This client is stable if being discharged, so assessment can be delayed.

C. A client scheduled for a cardiac ultrasound this morning: This is a non-urgent diagnostic procedure and does not take priority.

D. A client with controlled atrial fibrillation with a heart rate of 82: Controlled atrial fibrillation indicates stability, so this client can be assessed later.

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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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