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:

Sick sinus syndrome

Normal sinus rhythm

Sinus bradycardia

First degree heart block

Answer and Explanation

The Correct Answer is B

A. Sick sinus syndrome – This involves an abnormal SA node function, often with varying rhythm disturbances (e.g., sinus pauses, bradycardia-tachycardia). The strip described is regular and does not reflect these changes.
B. Normal sinus rhythm – The rhythm is regular, the PR interval is within normal limits (0.12–0.20 seconds), the heart rate is 60 beats/min (within the normal range of 60–100), and P waves precede each QRS complex consistently.
C. Sinus bradycardia – Although the rate is 60, which is at the low end of normal, it is not below 60. Bradycardia is defined as <60 bpm.
D. First-degree heart block – First-degree AV block is characterized by a prolonged PR interval >0.20 seconds. The PR interval here is 0.16 seconds, which is normal.

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Correct Answer is A

Explanation

A. Epinephrine – Epinephrine is the first-line treatment for anaphylactic shock. It rapidly reverses airway constriction, hypotension, and swelling by stimulating alpha and beta-adrenergic receptors, leading to bronchodilation, vasoconstriction, and increased cardiac output.
B. Dobutamine – Dobutamine is a positive inotrope used to treat cardiogenic shock and may support cardiac output, but it does not address the airway or allergic component of anaphylaxis.
C. Methylprednisolone – This corticosteroid may be given to reduce inflammation and prevent delayed reactions, but it has a slower onset of action and is not the priority in emergency management.
D. Furosemide – This diuretic is used in fluid overload or pulmonary edema, not in the management of anaphylaxis.

A. Client with infective endocarditis who has a murmur and splinter hemorrhages B. Client with rheumatic fever who has sharp chest pain with a deep breath C. Client with dilated cardiomyopathy who has bilateral crackles at the lung bases D. Client with acute aortic regurgitation whose blood pressure is 86/54 mm Hg

Correct Answer is D

Explanation

A. A murmur and splinter hemorrhages are expected findings in infective endocarditis and do not indicate an immediate life-threatening condition.
B. Sharp chest pain with inspiration in rheumatic fever may indicate pericarditis, which needs monitoring but is not immediately unstable.
C. Bilateral crackles suggest fluid overload in dilated cardiomyopathy, requiring attention, but not as urgent as hypotension in acute valve failure.
D. Acute aortic regurgitation with hypotension (BP 86/54 mm Hg) indicates a possible hemodynamic collapse and cardiogenic shock, making this client the highest priority for immediate assessment and intervention.

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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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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is has developed anaphylactic shock in response to the ingestion of strawberries. Which of the following medications should the nurse administer first?

Correct Answer is A

Explanation

After receiving report on the following clients, which client should the nurse assess first?

Correct Answer is D

Explanation

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