A 55-year-old patient with a history of hypertension is undergoing a routine ECG as part of their annual check-up. The ECG reveals a first-degree AV block. Which of the following statements about first-degree AV block is correct?
First-degree AV block is characterized by a prolonged PR interval greater than 0.20 seconds.
First-degree AV block is a type of heart block where some atrial impulses fail to reach the ventricles.
Patients with first-degree AV block typically present with symptoms such as syncope or dizziness.
First-degree AV block often requires immediate treatment with a pacemaker.
The Correct Answer is A
Rationale:
A. In first-degree atrioventricular (AV) block, all atrial impulses reach the ventricles, but conduction through the AV node is delayed. This delay is reflected on the ECG as a PR interval longer than 0.20 seconds, while the QRS complex remains normal. First-degree AV block is usually asymptomatic and often does not require treatment.
B. This description fits second-degree AV block, not first-degree. In first-degree block, no impulses are blocked, only delayed.
C. First-degree AV block is generally asymptomatic, and patients rarely experience symptoms. Symptoms such as syncope are more characteristic of higher-degree AV blocks.
D. Pacemaker therapy is not indicated for first-degree AV block unless it progresses to higher-degree AV block with symptomatic bradycardia. Immediate intervention is not needed in asymptomatic patients.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E"]
Explanation
Rationale:
A. A thready, weak pulse is typically associated with fluid volume deficit, not excess. Clients with FVE often have bounding pulses due to increased intravascular volume.
B. Dizziness is more commonly a sign of hypovolemia or hypotension, rather than fluid overload.
C. Edema occurs when excess fluid accumulates in the interstitial spaces, commonly in the lower extremities in clients with heart failure, making it a classic manifestation of FVE.
D. FVE usually causes distended (full) neck veins due to increased central venous pressure. Flat neck veins are associated with hypovolemia.
E. Rapid or unexplained weight gain in a client with HF is an early sign of fluid retention and is commonly used to monitor FVE.
Correct Answer is D
Explanation
Rationale:
A. While an absent pulse can occur in extreme cases of poor perfusion, it is not typical in atrial fibrillation. In AFib, the heart still contracts, though irregularly, so the pulse is usually detectable.
B. A bounding pulse is strong, forceful, and easily palpable, often seen in conditions like hyperthyroidism, fever, or aortic regurgitation. AFib does not typically produce a bounding pulse; instead, the pulse may feel weak or variable due to irregular ventricular contractions.
C. A regular pulse indicates consistent rhythm and timing between beats. In atrial fibrillation, the atria fire chaotically, leading to an irregularly irregular pulse. A regular pulse is more characteristic of normal sinus rhythm or controlled atrial flutter.
D. Some clients with AFib may have a slower rate, especially if they are on rate-controlling medications (e.g., beta-blockers or calcium channel blockers). However, the hallmark of AFib is irregularity in rhythm, which should be the primary focus of assessment.
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