A client in an urgent care clinic is reports having heart palpitations, and occasional shortness of breath. A 12-lead electrocardiogram (ECG) shows regular P- waves in a sawtooth formation at a rate of 260 beats per minute, and a regular ventricular rate of 82 beats per minute. The nurse should understand that this ECG finding represents which of the following conditions?

Atrial fibrillation

Atrial flutter

Unstable angina

Premature atrial contractions

Answer and Explanation

The Correct Answer is B

A.   Atrial fibrillation is characterized by irregularly irregular rhythms with no distinct P-waves. Instead, it has a chaotic baseline with fibrillatory waves. The ventricular response can be irregular and variable. The description provided (regular P-waves in a sawtooth formation) does not match the typical appearance of atrial fibrillation, which lacks regular P-waves and has an irregular rhythm.
B.   Atrial flutter is characterized by regular, sawtooth-shaped P-waves known as "F-waves" or "flutter waves." The classic pattern is referred to as "F-waves" with a "sawtooth" appearance, often seen in the inferior leads (II, III, aVF). The atrial rate is typically between 240 to 340 beats per minute, which fits the rate of 260 beats per minute in the description. The ventricular rate can be regular or irregular, depending on the degree of AV node conduction. A

C.   Unstable angina is a clinical diagnosis of chest pain due to myocardial ischemia. It is not associated with specific ECG findings related to the P-wave morphology or rate. The ECG findings described do not correspond to unstable angina, which would typically present with ST-segment changes or other signs of myocardial ischemia rather than a specific P-wave pattern.
D.   Premature atrial contractions (PACs) are early beats originating from the atria that interrupt the normal rhythm. They usually present as a single early beat with a different morphology of the P-wave compared to the sinus P-waves, but do not result in a regular sawtooth pattern or a sustained rhythm at high rates like the one described.

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Correct Answer is D

Explanation

A. Ethnicity alone is not a known risk factor for ALS. ALS has a relatively uniform incidence across different ethnic groups. Studies have not demonstrated a significant correlation between ALS and being of Asian descent specifically.

B. There is limited evidence suggesting that consuming well water could be associated with an increased risk of ALS, particularly if the well water is contaminated with certain toxins or heavy metals. However, this is not a widely established risk factor and is less directly linked to ALS compared to other known risk factors.
C. Working in agriculture has been identified as a potential risk factor for ALS. Agricultural workers are often exposed to various environmental toxins, pesticides, and herbicides, which have been associated with an increased risk of developing ALS. This occupational exposure is considered a significant risk factor for the disease.
D. Military veterans are known to have an increased risk of developing ALS. Several studies have shown that veterans, particularly those who served in combat or were exposed to specific environmental hazards during their service, have a higher incidence of ALS compared to the general population.

A. Avoid foods that are high in vitamin A. B. This medication may increase your blood sugar. C. Do not take Verteporfin on an empty stomach. D. Avoid sunlight and other intense light for the next five days.

Correct Answer is D

Explanation

A. While vitamin A can interact with some medications, it does not have a significant effect on verteporfin.
B. Verteporfin does not typically affect blood sugar levels.
C. Verteporfin is usually administered intravenously, so it is not taken orally.
D. Verteporfin is a photosensitizing agent used in photodynamic therapy for age-related macular degeneration. After treatment with verteporfin, the client should avoid sunlight and other intense light for several days to prevent a severe sunburn-like reaction. This is because verteporfin makes the skin and eyes more sensitive to light.

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Naxlex Comprehensive Predictor Exams

A client is admitted to the hospital with a diagnosis of Amyotrophic Lateral Sclerosis (ALS). Which finding is consistent with known risk factors for this disease?

Correct Answer is D

Explanation

A client with age-related macular degeneration (AMD) is undergoing photodynamic therapy with the medication Verteporfin. What should the nurse include in the discharge teaching for this client?

Correct Answer is D

Explanation

The nurse is providing care for a geriatric patient with loss of hearing acuity over the past several years. Which statement by the nurse is most accurate?

The patient is admitted with upper GI bleeding following an episode of forceful vomiting due to excessive alcohol intake. The nurse suspects a Mallory-Weiss tear. Which of the following is true of a Mallory-Weiss tear?

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

Which nursing intervention is the most appropriate to implement for a client who experiencing weight loss due to nausea caused by chemotherapy?

A nurse in an eye clinic is obtaining a health history from a client who is being evaluated for suspected cataracts. The nurse understands that which of the following medications is associated with an increased risk of developing cataracts?

A nurse is caring for a client with an acute heart failure exacerbation. Which of the following medications are commonly prescribed to manage heart failure? (Select all that apply.)

A nurse is caring for a client who has been diagnosed with heparin-induced thrombocytopenia (HIT). Which of the following clinical manifestations should the nurse recognize as the most concerning for a client with this condition?