A nurse is reviewing a client’s cardiac rhythm strips and notes a constant P-R interval of 0.35 seconds.

Which of the following dysrhythmias is the client displaying

Atrial fibrillation.

Complete heart block

First-degree atrioventricular block

Premature atrial complexes

Answer and Explanation

The Correct Answer is C

. Answer and explanation.

The correct answer is choice C, first-degree atrioventricular block.

This is because the PR interval is longer than normal, which indicates a delay in the conduction of electrical impulses from the atria to the ventricles through the AV node. A normal PR interval is 0.12 to 0.2 seconds, or 3 to 5 small squares on the EKG strip.

In this case, the PR interval is 0.35 seconds, which is more than 5 small squares.

Choice A is wrong because atrial fibrillation is a type of arrhythmia where the atria beat irregularly and rapidly, producing chaotic and variable P waves and an irregular ventricular response.

There is no constant PR interval in atrial fibrillation.

Choice B is wrong because complete heart block is a type of arrhythmia where there is no conduction of electrical impulses from the atria to the ventricles, resulting in independent and dissociated atrial and ventricular rhythms.

There are no consistent P waves or PR intervals in complete heart block.

Choice D is wrong because premature atrial complexes are extra beats that originate from the atria and interrupt the normal sinus rhythm.

They produce abnormal P waves that are different from the sinus P waves, and may have a shorter or longer PR interval depending on the timing of the impulse.

However, they do not cause a constant prolongation of the PR interval.

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Correct Answer is C

Explanation

The correct answer is choice C. Determine the client’s Glasgow Coma Scale score. This is because the Glasgow Coma Scale (GCS) is a tool to assess the level of consciousness and neurological status of a client who has a closed head injury. The GCS score can help guide the priority of interventions and the need for further diagnostic tests.

Choice A is wrong because an MRI of the brain is not the first action to take for a client who has a closed head injury. An MRI may be indicated later to evaluate the extent of brain damage, but it is not an emergency procedure.

Choice B is wrong because mannitol IV bolus is a medication that reduces intracranial pressure (ICP) by drawing fluid out of the brain tissue. However, mannitol should not be administered before confirming the presence and degree of increased ICP, which can be done by measuring the GCS score and other vital signs.

Choice D is wrong because inserting an indwelling urinary catheter for the client is not the first action to take for a client who has a closed head injury. A urinary catheter may be needed to monitor fluid balance and renal function, but it is not an urgent intervention.

A. "I will eat fish for dinner at least twice per week.". B. "I will limit my morning coffee to no more than two cups.". C. "I will eat small, frequent meals.". D. "I should expect my bowel movements to be pale in color". E. "I will notify my provider if my urine is dark.".

Correct Answer is ["C","D","E"]

Explanation

The correct answer is choice CDE.

Choice A rationale:

Eating fish for dinner at least twice per week is not specifically recommended for pancreatitis patients. A low-fat diet is generally advised, but the frequency of fish consumption is not a key point in discharge teaching.

Choice B rationale:

Limiting coffee intake is not a primary focus in pancreatitis discharge instructions. While caffeine can irritate the digestive system, the emphasis is more on avoiding alcohol and fatty foods.

Choice C rationale:

Eating small, frequent meals is recommended to avoid overloading the digestive system and to help manage symptoms of pancreatitis.

Choice D rationale:

Pale bowel movements can indicate a problem with bile flow, which is not a normal expectation for pancreatitis patients. This could suggest a complication that needs medical attention.

Choice E rationale:

Dark urine can be a sign of dehydration or liver issues, which should be reported to a healthcare provider as it may indicate a complication.

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A nurse is reviewing a client’s cardiac rhythm strips and notes a constant P-R interval of 0.35 seconds. Which of the following dysrhythmias is the client displaying

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is caring for a client who has a closed head injury. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A nurse in an emergency department is caring for a client. Exhibits The nurse is preparing to discharge the client. Which of the following statements by the client indicate an understanding of the discharge teaching? Select all that apply.

Correct Answer is ["C","D","E"]

Explanation

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A nurse is reviewing a client’s cardiac rhythm strips and notes a constant P-R interval of 0.35 seconds.

Which of the following dysrhythmias is the client displaying