The nurse is caring for a client in the coronary care unit and the monitor depicts the rhythm shown below. What is the nurse’s interpretation of this rhythm?

Second degree AV block- Mobitz II

Sinus bradycardia with first degree AV block

Second degree AV block- Mobitz I

Third degree heart block

Answer and Explanation

The Correct Answer is C

A.   Mobitz II is a type of second-degree AV block characterized by constant PR intervals and sudden dropped QRS complexes (i.e., the PR interval does not lengthen progressively). This is a more serious block because the dropped beats are unpredictable and could lead to complete block.
B.   Sinus bradycardia is a slower-than-normal heart rate (usually less than 60 beats per minute) that originates from the sinus node. First-degree AV block is characterized by a prolonged PR interval, but unlike second-degree block, there are no dropped QRS complexes.
C.   Mobitz I (Wenckebach) is a second-degree AV block where the PR interval gradually lengthens with each successive beat until a QRS complex is dropped. After the dropped beat, the cycle repeats. This is a relatively benign block and often resolves without intervention, though it requires monitoring.
D.   Third-degree heart block (also known as complete heart block) occurs when there is no communication between the atria and ventricles. The atria and ventricles beat independently of each other. There are no relationship between the P waves and QRS complexes, and the ventricular rate is typically slower than the atrial rate.

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Correct Answer is B

Explanation

A. The pacemaker wire for a DDD device is placed in the right atrium and right ventricle, not the left ventricle.
B. This is the correct description of a DDD pacemaker, which has wires in both the right atrium and right ventricle to monitor and pace both chambers when needed.
C. This is incorrect because a DDD pacemaker does not pace both ventricles.
D. This is inaccurate because a DDD pacemaker does not fire with every heartbeat; it only fires when the heart’s natural electrical activity is insufficient.

A. Giving away valued possessions B. Engaging in high-risk behaviors C. Talkative, with pressured speech D. Guilt, decreased self-esteem

Correct Answer is A

Explanation

A. Giving away valued possessions - This is a classic sign of suicidal ideation, as individuals may feel they no longer need their belongings or want to say goodbye to loved ones in a symbolic way.
B. Engaging in high-risk behaviors - While high-risk behaviors can be a sign of depression, they are not necessarily indicative of suicidal thoughts.
C. Talkative, with pressured speech - This could be indicative of a manic episode or high anxiety, but it is not a common sign of suicidal behavior.
D. Guilt, decreased self-esteem - Although guilt and low self-esteem are symptoms of depression, they do not directly indicate suicidal thoughts or behaviors.

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The nurse is caring for a client in the coronary care unit and the monitor depicts the rhythm shown below. What is the nurse’s interpretation of this rhythm?

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Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions to a client who has had a permanent pacemaker inserted. The information in the chart indicates that the device is a DDD. What will the nurse explain about this pacemaker?

Correct Answer is B

Explanation

Which behavior observed by the nurse causes a suspicion that a depressed client may be suicidal?

Correct Answer is A

Explanation

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