A nurse is reviewing a client's cardiac monitor for dysrhythmias. Which of the following findings should the nurse identify as an indication for the placement of a permanent pacemaker?

Vasovagal bradycardia without syncope

Complete AV block with rates slower than 40/min

Sinus tachycardia with rates faster than 80/min

Asymptomatic second-degree AV block

Answer and Explanation

The Correct Answer is B

A complete AV block (also called third-degree AV block) is a type of heart block in which there is no electrical communication between the atria and ventricles. This means that the atria and ventricles beat independently of each other, resulting in a slow and irregular pulse. A complete AV block can cause symptoms such as dizziness, fainting, chest pain, shortness of breath, and heart failure.

A permanent pacemaker is a device that sends electrical impulses to the heart to regulate its rhythm and prevent bradycardia (slow heart rate). A permanent pacemaker is indicated for clients with complete AV block and rates slower than 40/min or symptomatic bradycardia.

The other options are not indications for a permanent pacemaker. Vasovagal bradycardia is a temporary drop in heart rate and blood pressure caused by a stimulus that triggers the vagus nerve, such as pain, stress, or straining.

It usually resolves on its own or with simple measures, such as lying down or elevating the legs. Sinus tachycardia is a normal increase in heart rate in response to physical or emotional stress, such as exercise, fever, or anxiety. It usually does not require treatment unless it is caused by an underlying condition or causes symptoms.

Asymptomatic second-degree AV block is a type of heart block in which some of the electrical impulses from the atria are blocked from reaching the ventricles. It may not cause any symptoms or affect the overall heart rate. It may be benign or transient, or it may progress to a more serious type of heart block. It may require monitoring or medication, but not a permanent pacemaker unless it causes symptomatic bradycardia.

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Correct Answer is C

Explanation

The nurse should expect disequilibrium with movement if the client has impaired function of the vestibulocochlear nerve, as this nerve is responsible for hearing and balance. Deviation of the tongue from midline indicates impairment of the hypoglossal nerve (cranial nerve XII), loss of peripheral vision indicates impairment of the optic nerve (cranial nerve II), and inability to smell indicates impairment of the olfactory nerve (cranial nerve I).

A. Recommend staying at a local shelter until the client can afford the bill. B. Contact the local Department of Health and Human Services for the client. C. Contact the client's family members to tell them the client's financial status. D. Provide the client with written information about the dangers of hypothermia.

Correct Answer is B

Explanation

This is because older adults are at increased risk of hypothermia, which is a potentially life-threatening condition that occurs when the body temperature drops below 35° C (95° F).

Hypothermia can cause confusion, drowsiness, slurred speech, slow heartbeat, shallow breathing, and loss of consciousness. Some factors that increase the risk of hypothermia in older adults are low indoor temperature, inadequate clothing, poor nutrition, chronic illness, medication use, and social isolation.

The nurse should contact the local Department of Health and Human Services for the client to help them access resources and programs that can assist them with paying their heating bills or finding alternative housing options. The nurse should also educate the client on how to prevent hypothermia by wearing warm clothing, eating well-balanced meals, drinking warm fluids, avoiding alcohol and caffeine, and staying active.

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A nurse is reviewing a client's cardiac monitor for dysrhythmias. Which of the following findings should the nurse identify as an indication for the placement of a permanent pacemaker?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing a cranial nerve assessment on a client following a head injury. Which of the following findings should the nurse expect if the client has impaired function of the vestibulocochlear nerve (cranial nerve VIII)?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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