The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, QRS complex wide and QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as

ventricular tachycardia.

ventricular fibrillation.

sinus tachycardia.

atrial flutter.

Answer and Explanation

The Correct Answer is A

A. Ventricular tachycardia is characterized by a ventricular rate >100 bpm, regular rhythm, no visible P waves, and wide QRS complexes (>0.12 seconds). The findings described—ventricular rate of 162, regular R-R intervals, no visible P waves, and a QRS duration of 0.18 seconds—are consistent with ventricular tachycardia.
B. Ventricular fibrillation shows a chaotic, irregular rhythm with no identifiable QRS complexes, which is not the case here.
C. Sinus tachycardia would have visible P waves and a normal QRS duration.
D. Atrial flutter typically has "sawtooth" flutter waves and a more organized atrial rhythm with a distinct P wave pattern, which is absent in this scenario.

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Correct Answer is B

Explanation

A. Spinal cord perfusion is not monitored with a pulmonary artery catheter; it typically requires different neuromonitoring techniques.
B. Hemodynamic status is accurately monitored using a pulmonary artery catheter (also called a Swan-Ganz catheter), which provides information on cardiac output, pulmonary artery pressures, and other cardiovascular parameters.
C. Intracranial pressure is monitored using devices like an intraventricular catheter or subarachnoid bolt, not a pulmonary artery catheter.
D. Renal function is assessed through laboratory tests (e.g., BUN, creatinine) and urine output, not via a pulmonary artery catheter

A. Decreased cardiac output and increased MAP B. Decreased cardiac output and decreased MAP C. Increased cardiac output and increased afterload D. Increased cardiac output and increased MAP

Correct Answer is B

Explanation

A. Decreased cardiac output with increased mean arterial pressure (MAP) does not typically occur in cardiogenic shock. In shock states, MAP tends to decrease.
B. Decreased cardiac output and decreased MAP are the hallmark pathophysiologic changes in cardiogenic shock following a myocardial infarction. The damaged myocardium cannot pump effectively, leading to poor perfusion and hypotension.
C. Increased cardiac output and increased afterload are not features of cardiogenic shock; in fact, cardiac output is decreased.
D. Increased cardiac output and increased MAP suggest improved perfusion, not the compromised state seen in cardiogenic shock.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for transfer to the ICU for placement of a pulmonary artery catheter. The nurse should explain to the client that this catheter is used to monitor which of the following conditions?

Correct Answer is B

Explanation

What are the pathophysiologic changes that place a client who has suffered a myocardial infarction at risk for cardiogenic shock?

Correct Answer is B

Explanation

A nurse is assessing an ECG rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second. The overall heart rate is 60 beats/min. The nurse assesses the cardiac rhythm as:

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