A client comes to the emergency department with complaints of chest pain after using cocaine. The nurse assesses the client and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing?

Sinus bradycardia

Ventricular tachycardia

Normal sinus rhythm

Sinus tachycardia

Answer and Explanation

The Correct Answer is D

A. Sinus bradycardia is characterized by a heart rate below 60 beats/min, which is inconsistent with this client’s elevated heart rate of 128.
B. Ventricular tachycardia is a potentially life-threatening rhythm with wide QRS complexes, usually not the immediate expected rhythm without other signs such as hypotension or loss of consciousness.
C. Normal sinus rhythm has a heart rate between 60–100 beats/min; this client’s rate of 128 exceeds that range.
D. Sinus tachycardia is the most likely rhythm, especially in a client who has used cocaine, a stimulant known to increase sympathetic nervous system activity, leading to increased heart rate and elevated blood pressure.

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Correct Answer is A

Explanation

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.

A. Ventricular tachycardia B. Sinus tachycardia C. Supraventricular tachycardia D. Sinus bradycardia

Correct Answer is D

Explanation

A. Ventricular tachycardia is less commonly triggered by suctioning.
B. Sinus tachycardia may occur but is not the most common arrhythmia during suctioning.
C. Supraventricular tachycardia is not typically associated with suctioning.
D. Sinus bradycardia is the most common arrhythmia caused by vagal stimulation during endotracheal suctioning.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is A

Explanation

The nurse who is caring for a client in ICU on a ventilator assesses a need for suctioning and is aware that the most common cardiac arrhythmia occurring during endotracheal suctioning is:

Correct Answer is D

Explanation

The nurse providing discharge teaching to a client admitted with pericarditis. The nurse informs the client that pericarditis can lead to:

The nurse notes premature ventricular contractions (PVCs) while suctioning a client's endotracheal tube. Which action by the nurse is a priority?

A nurse is caring for a client who is at risk for developing shock. Which of the following findings is the earliest indicator that this complication is occurring?

A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective?

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