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. Maintain hyperventilation to a PaCO2 of 15 to 20 mm Hg. Hyperventilation can reduce ICP by causing vasoconstriction of cerebral blood vessels; however, a PaCO2 as low as 15–20 mmHg may lead to excessive vasoconstriction, reducing cerebral blood flow and causing cerebral ischemia. A PaCO2 target closer to 30–35 mmHg is typically recommended, and even this is used cautiously.

B. Routinely suction to prevent accumulation of respiratory secretions. Suctioning can increase ICP due to stimulation of the cough reflex. It should be performed only as needed and in a way that minimizes stimulation, such as preoxygenation and limiting suction duration.

C. Encourage visitation to prevent feelings of isolation. While social support is important, minimizing environmental stimuli (including limiting visitation) is crucial for clients with increased ICP to prevent overstimulation and further increases in ICP.

D. Avoid positioning the client with neck and hip flexion. Maintaining proper alignment of the head and neck is essential to promote venous drainage and reduce intracranial pressure (ICP). Flexion of the neck or hips can impede venous outflow, exacerbate ICP, and compromise cerebral perfusion.

A. Atrial tachycardia B. Ventricular fibrillation C. Atrial flutter D. Sinus bradycardia

Correct Answer is C

Explanation

A. Atrial tachycardia: Atrial tachycardia is a rapid heart rhythm originating from the atria, but it does not have the characteristic "sawtooth" pattern seen in atrial flutter.

B. Ventricular fibrillation: Ventricular fibrillation is a chaotic rhythm originating from the ventricles, characterized by irregular, rapid waves with no discernible P waves or QRS complexes.

C. Atrial flutter: Atrial flutter is recognized by a "sawtooth" pattern of P waves, indicating rapid atrial depolarizations.

D. Sinus bradycardia: Sinus bradycardia is a slow but regular rhythm originating from the sinus node, with normal P waves and QRS complexes.

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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

Explanation

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Correct Answer is C

Explanation

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