A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P wave?

Slow repolarization of ventricular Purkinje fibers

Atrial depolarization

Early ventricular repolarization

Ventricular depolarization

Answer and Explanation

The Correct Answer is B

The P wave is the first wave on the ECG strip and represents the electrical activity of the atria. It reﬂects the depolarization of the atrial myocardium, which is the process of changing the electrical charge of the cardiac cells from negative to positive, triggering a contraction. The P wave precedes the QRS complex, which represents ventricular depolarization, and the T wave, which represents ventricular repolarization.

The other options are not correct because:

a. Slow repolarization of ventricular Purkinje fibers. This statement is incorrect because it describes the U wave, which is a small and sometimes invisible wave that follows the T wave on the ECG strip. It reﬂects the repolarization of the ventricular Purkinje fibers, which are specialized cardiac cells that conduct electrical impulses to the ventricles. The U wave is more prominent in conditions that cause hypokalemia, such as diuretic use or vomiting.

c. Early ventricular repolarization. This statement is incorrect because it describes the ST segment, which is the ﬂat line between the QRS complex and the T wave on the ECG strip. It reﬂects the early phase of ventricular repolarization, which is the process of restoring the electrical charge of the cardiac cells to negative after a contraction. The ST segment can be elevated or depressed in conditions that cause myocardial ischemia or injury, such as angina or myocardial infarction.

d. Ventricular depolarization. This statement is incorrect because it describes the QRS complex, which is the largest and most visible wave on the ECG strip. It reﬂects the depolarization of the ventricular myocardium, which triggers a ventricular contraction. The QRS complex follows the P wave and precedes the T wave on the ECG strip.

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Correct Answer is B

Explanation

Planning to slow down if tired the day after exercising is a statement that indicates the client understands the importance of pacing activities and avoiding overexertion, which can worsen heart failure symptoms.

a. "I should use naproxen to manage discomfort." is not correct, as naproxen is a nonsteroidal anti-inﬂammatory drug (NSAID) that can cause ﬂuid retention, increase blood pressure, and worsen heart failure. The client should avoid NSAIDs and use other analgesics, such as acetaminophen, unless contraindicated.

c. "I will read food labels and limit my sodium to 4 grams per day." is not appropriate, as 4 grams of sodium per day is too high for a client who has congestive heart failure. The client should limit sodium intake to 2 grams or less per day, as sodium can cause ﬂuid retention and increase the workload of the heart.

d. "I will take my diuretic before sleep and drink ﬂuids during the day." is not advisable, as taking a diuretic before sleep can cause nocturia and disrupt the sleep cycle, which can aﬀect the quality of life and cardiac function. The

A. "It's not unusual to feel that way at first, but once you learn the routine, you'll enjoy it." B. "Exercise is good for you and good for your heart." C. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely." D. "Your doctor is the expert here, and I'm sure he would only recommend what is best for you."

Correct Answer is C

Explanation

Choice A reason:

This statement is incorrect because it trivializes the patient's concerns and implies that enjoyment is the primary goal, which is not the case. The main purpose of cardiac rehabilitation is to improve health outcomes, not just to make the routine enjoyable.

Choice B reason:

While exercise is beneficial for heart health, this statement is too general and does not address the specific benefits of cardiac rehabilitation for someone who has had a myocardial infarction.

The correct answer is C:

"Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely." Cardiac rehabilitation is crucial for patients who have experienced a myocardial infarction. It provides a structured program that includes exercise, education, and support to help patients improve their cardiovascular health and prevent future cardiac events.

Choice D reason:

Deferring to the doctor's expertise does not educate the patient about the benefits of cardiac rehabilitation. It's important for patients to understand why they are participating in the program.

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A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P wave?

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