A nurse is analyzing a client's electrocardiogram (ECG) strip and identifies the following information:

Heart rate: 92/min

Rhythm: Irregular

P wave: Unable to identify

PR interval: Unable to measure

QRS duration: O. 1 0 seconds
Based upon this information, the nurse should interpret the client's rhythm as indicating which of the following?

Atrial fibrillation

Sinus bradycardia

Supraventricular tachycardia

First-degree heart block

Answer and Explanation

The Correct Answer is A

A. Atrial fibrillation: Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of identifiable P waves, and irregular ventricular response. The heart rate in atrial fibrillation can be variable, and the absence of identifiable P waves indicates disorganized atrial electrical activity.

B. Sinus bradycardia: Sinus bradycardia is characterized by a regular rhythm with a heart rate less than 60 beats per minute (bpm) and normal P waves preceding each QRS complex. In sinus bradycardia, the PR interval and QRS duration are typically within normal limits.

C. Supraventricular tachycardia: Supraventricular tachycardia (SVT) is characterized by a regular rhythm with a heart rate greater than 100 bpm. SVT typically presents with narrow QRS complexes and may or may not have discernible P waves.

D. First-degree heart block: First-degree heart block is characterized by a prolonged PR interval (>0.20 seconds) but maintains a regular rhythm with normal QRS duration. In first-degree heart block, P waves are typically identifiable, and the rhythm is not irregular.

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Correct Answer is A

Explanation

Answer: A. Ensuring that the client and their family are kept informed about the client's care

Rationale:

A. Ensuring that the client and their family are kept informed about the client's care:
This action is the priority because communication is vital in managing a client with multiple organ dysfunction syndrome (MODS). Keeping the client and their family informed can help them understand the seriousness of the condition, the plan of care, and potential outcomes. It also fosters trust and ensures that the family can make informed decisions regarding the client's care.

B. Being aware of the client's wishes regarding care:
While being aware of the client’s wishes is important, especially in critical conditions like MODS, the priority lies in ensuring ongoing communication about the client's current status and treatment. Understanding the client's wishes can guide care but should follow the immediate need for clear communication about the evolving situation.

C. Scheduling periods of rest for the client:
Rest is essential for recovery, particularly in clients with MODS, but scheduling rest periods is a part of implementing care rather than a primary action. It can be planned based on the client’s needs and condition but does not take precedence over ensuring that the family is informed.

D. Discussing the client's resting times with the family:
While involving the family in discussions about the client's care is beneficial, the immediate priority is to ensure they are fully informed about the overall condition and care plan. This discussion can occur after establishing a solid communication foundation regarding the client's status and care approach.

A. Septal myectomy B. Synchronized electrical cardioversion C. Pericardiocentesis D. Pericardial window

Correct Answer is B

Explanation

A. Septal myectomy: Septal myectomy is a surgical procedure primarily used to treat hypertrophic cardiomyopathy (HCM), not atrial fibrillation. It involves removing a portion of the thickened septal wall in the heart to improve blood flow.

B. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to convert abnormal heart rhythms, such as atrial fibrillation, back to normal sinus rhythm. It involves delivering a synchronized electrical shock to the heart at a specific point in the cardiac cycle to restore normal rhythm.

C. Pericardiocentesis: Pericardiocentesis is a procedure used to remove fluid from the pericardial sac surrounding the heart. It is typically performed to relieve cardiac tamponade or to investigate the cause of pericardial effusion.

D. Pericardial window: A pericardial window is a surgical procedure performed to create a permanent opening in the pericardium, the sac surrounding the heart. It is usually done to drain fluid or air from the pericardial space, often in cases of recurrent pericardial effusion or cardiac tamponade.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who has multiple organ dysfunction syndrome (MODS). Which of the following actions is the priority when planning care for this client?

Correct Answer is A

Explanation

Rationale:

A nurse is planning care for a client who has atrial fibrillation and reports heart palpitations, lightheadedness, and shortness of breath. Which of the following procedures should the nurse anticipate for this client?

Correct Answer is B

Explanation

A nurse is assessing a client who has peripheral artery disease for potential safety concerns. Which of the following client statements should the nurse report to the provider?

A nurse is obtaining a preoperative medical and surgical history from a client scheduled for a cataract extraction procedure. Which of the following client statements require further investigation by the nurse?

A nurse is planning care for a client who has increased intracranial pressure. The nurse should understand that enteral nutrition should begin within 24 to 48 hr to help prevent which of the following complications?

A nurse is assessing a client who has peripheral venous disease. Which of the following findings should the nurse recognize as a manifestation of peripheral venous disease?

A nurse is providing discharge education to a client who has valvular heart disease and peripheral vascular disease. Which of the following should the nurse include in the teaching about valvular heart disease?

A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

A nurse is caring for a group of clients with dementia. The nurse recognizes which of the following factors as reasons for the growing numbers of clients diagnosed with dementia in the United States? (Select All that Apply.)