The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip because:

The view of the electrical current changes in relation to the lead placement.

Conduction of the heart differs with lead placement.

Electrocardiogram (ECG) equipment has malfunctioned.

The circadian rhythm has changed.

Answer and Explanation

The Correct Answer is A

A. The view of the electrical current changes in relation to the lead placement – Each ECG lead offers a different angle or view of the heart's electrical activity, so the waveforms in leads I, II, and III naturally look different. This variation helps clinicians assess different parts of the heart.
B. Conduction of the heart differs with lead placement – The heart's electrical conduction system functions independently of lead placement; only the view of the conduction changes.
C. Electrocardiogram (ECG) equipment has malfunctioned – Lead differences are expected and normal; this is not a sign of malfunction.
D. The circadian rhythm has changed – Circadian rhythms affect general physiological patterns but do not cause variation in ECG lead appearance.

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Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

The nurse should monitor the client for pneumothorax and lead dislodgement following permanent pacemaker placement.

Rationale

Pneumothorax: The procedure involves central venous access, often via the subclavian vein, which increases the risk of puncturing the pleura and causing a pneumothorax. Signs include:

Lead dislodgement: Movement or tension on the pacing lead can result in loss of pacemaker capture or failure to pace effectively. This is a priority during the first 24 hours. Indicators include:

A. Ventricular tachycardia B. Multifocal premature ventricular contractions C. Ventricular couplets D. Ventricular bigeminy

Correct Answer is D

Explanation

A. Ventricular tachycardia is a run of three or more consecutive ventricular beats at a rapid rate, not every other beat.
B. Multifocal premature ventricular contractions (PVCs) arise from different ventricular foci and have different shapes, but this scenario describes uniform shape and consistent pattern.
C. Ventricular couplets are two consecutive PVCs, not a pattern where every other beat is abnormal.
D. Ventricular bigeminy is the correct term for a rhythm in which every other beat is a premature ventricular contraction (PVC). These PVCs typically have no visible P wave and a wide, bizarre QRS complex, matching the description given.

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The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip because:

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Naxlex Comprehensive Predictor Exams

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

The nurse notes that a client's cardiac monitor shows that every other beat is earlier than expected, has no visible P wave, and has a QRS complex that is wide and bizarre in shape. How will the nurse document the rhythm?

Correct Answer is D

Explanation

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