The nurse is teaching a beginning ECG class to staff nurses. As the nurse begins to discuss the parts of the ECG complex, one of the students asks what the normal order of conduction through the heart is. The correct response would be which of the following?

SA node, AV node, bundle of His, right and left bundle branches, and the Purkinje fibers

SA node, AV node, bundle of His, the Purkinje fibers, and the right and left bundle branches

AV node, SA node, bundle of His, right and left bundle branches, and the Purkinje fibers

SA node, AV node, right and left bundle branches, bundle of His, and the Purkinje fibers

Answer and Explanation

The Correct Answer is A

A. This is the correct sequence of normal electrical conduction through the heart: the impulse originates in the sinoatrial (SA) node, travels to the atrioventricular (AV) node, then to the bundle of His, down the right and left bundle branches, and finally through the Purkinje fibers.
B. This choice places the Purkinje fibers before the bundle branches, which is incorrect.
C. The AV node does not initiate conduction; the SA node is the natural pacemaker of the heart.
D. This sequence incorrectly places the bundle branches before the bundle of His.

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Correct Answer is C

Explanation

A. Anaphylactic shock is a life-threatening allergic reaction, but it is less common and less frequently the cause of ICU deaths compared to septic shock.
B. Neurogenic shock results from spinal cord injuries or central nervous system damage and is relatively rare.
C. Septic shock is the most common cause of death in intensive care units in the United States. It results from overwhelming infection and leads to systemic inflammation, vasodilation, and multi-organ dysfunction.
D. Cardiogenic shock occurs due to the heart’s inability to pump effectively, often after a major myocardial infarction, but it is not the leading cause of death in ICUs.

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

Correct Answer is D

Explanation

A. Ventricular tachycardia presents with wide QRS complexes (usually >0.12 second), and the rhythm is typically regular—not irregular as seen here.
B. Sinus tachycardia has identifiable P waves before each QRS complex and a regular rhythm, which is not the case here.
C. Ventricular fibrillation presents as a chaotic, irregular waveform with no identifiable QRS complexes, resulting in no effective cardiac output—this is more severe than the rhythm described.
D. Atrial fibrillation is characterized by the absence of P waves, irregularly irregular rhythm, wavy baseline (fibrillatory waves), and often a rapid ventricular response, such as the heart rate of 120 bpm observed in this client.

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The nurse is teaching a beginning ECG class to staff nurses. As the nurse begins to discuss the parts of the ECG complex, one of the students asks what the normal order of conduction through the heart is. The correct response would be which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Nurses in intensive care units commonly care for clients in varying stages of various types of shock. Which of the following is the most common cause of death in intensive care units in the United States?

Correct Answer is C

Explanation

A nurse is caring for a client on a cardiac monitor and whose rhythm suddenly changes. There are no P waves; instead she observes wavy lines. The QRS complexes measure 0.08 second and are irregular. The client's heart rate is 120 beats/minute. The nurse interprets that this rhythm is:

Correct Answer is D

Explanation

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