The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?
2nd degree Mobitz Il
Atrial flutter
Sinus bradycardia
1st degree AV block
The Correct Answer is D
A. This type of AV block is characterized by a progressively lengthening PR interval until a QRS complex is dropped (a blocked beat). A PR interval of 0.28 seconds could be seen in 2nd degree Mobitz I (Wenckebach), not Mobitz II, which has a more irregular pattern of dropped beats
B. Atrial flutter: Atrial flutter is a type of arrhythmia characterized by rapid atrial rates (typically around 250-350 beats per minute) with a sawtooth pattern of P-waves. It does not relate to the PR interval, but rather the atrial rhythm.
C. Sinus bradycardia: Sinus bradycardia is characterized by a slower-than-normal heart rate (less than 60 beats per minute), but this does not affect the PR interval directly. A normal PR interval (0.12-0.20 seconds) can still be seen in sinus bradycardia, so the prolonged PR interval in this case makes sinus bradycardia less likely.
D. 1st degree AV block: In 1st degree AV block, the PR interval is consistently prolonged, usually more than 0.20 seconds, but it is still a constant, non-variable delay in the conduction between the atria and ventricles. A PR interval of 0.28 seconds (which is longer than normal but consistent) is characteristic of a first-degree AV block, making it the correct answer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Sodium is crucial for maintaining normal cellular function, especially for nerve impulses and muscle contractions. However, sodium imbalances typically affect the general function of the heart, and sodium abnormalities are not commonly associated with torsades de pointes, which is a type of polymorphic ventricular tachycardia.
B. Magnesium plays a critical role in the electrical stability of the heart and helps regulate potassium and calcium channels, which are involved in the cardiac action potential. Hypomagnesemia (low magnesium) is a well-known risk factor for torsades de pointes, a specific type of polymorphic ventricular tachycardia that is associated with QT interval prolongation. In this case, the magnesium level is 2.5 mg/dL, which is above the normal range (1.6-2.2 mg/dL), suggesting hypermagnesemia.
C. Calcium is vital for proper muscle function, including the heart muscle, and is essential for electrical conduction. Hypocalcemia (low calcium) can lead to QT interval prolongation, which in turn increases the risk for arrhythmias such as torsades de pointes. However, in this case, the calcium level is 8.0 mg/dL, which is only slightly below the normal range (8.2-10.2 mg/dL), making calcium a less likely primary contributor to torsades de pointes in this situation.
D. Potassium plays a crucial role in regulating the resting membrane potential and action potentials in cardiac cells. Hypokalemia (low potassium) can lead to QT prolongation and increase the risk of arrhythmias, including torsades de pointes. However, in this case, the potassium level is 2.8 mEq/L, which is low (normal range: 3.5-5.3 mEq/L), and hypokalemia is more commonly associated with arrhythmias such as torsades de pointes than hyperkalemia (high potassium).
Correct Answer is A
Explanation
A. A decreased D-dimer level is a positive outcome, as D-dimer is elevated in DIC due to the formation of clots and the breakdown of fibrin. Lower levels indicate less clot formation and better control of the condition.
B. Fibrinogen levels are typically low in DIC due to consumption of clotting factors. Elevated fibrinogen in this case would be a negative indicator, suggesting that clotting is not resolving.
C. A decreased platelet count is a hallmark of DIC and indicates ongoing consumption of platelets due to widespread clotting. A decrease would not be a positive outcome.
D. A prolonged PT is another indicator of DIC, suggesting impaired clotting function. This is not a positive outcome.
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