A nurse is reviewing the sequence of the cardiac cycle. The nurse recognizes that the electrical stimulus of the cardiac cycle follows which sequence?

AV node-• SA node-• bundle of His -• Erb's Point

Bundle of His -• AV node -• SA node -• Erb's Point

AV node -• SA node -• bundle of His -• bundle branches

SA node -• AV node -• bundle of His -• bundle branches

Answer and Explanation

The Correct Answer is D

A) AV node → SA node → bundle of His → Erb's Point:
This sequence is incorrect because the electrical impulse of the heart starts at the SA (sinoatrial) node, not the AV (atrioventricular) node. The SA node is the natural pacemaker of the heart, initiating the electrical signal. The correct order of conduction is SA node → AV node → bundle of His → bundle branches, and finally, the Purkinje fibers. Erb's Point is an anatomical reference point for auscultation, not part of the electrical conduction pathway.

B) Bundle of His → AV node → SA node → Erb's Point:
This sequence is also incorrect. The electrical impulse originates at the SA node, not the bundle of His. The SA node stimulates the AV node, which in turn sends the signal to the bundle of His and then to the bundle branches. This pathway is essential for coordinating the contraction of the heart muscle, starting from the atria and moving to the ventricles.

C) AV node → SA node → bundle of His → bundle branches:
This sequence is reversed and incorrect. The impulse starts at the SA node, not the AV node. The SA node fires first, sending the electrical signal to the AV node, and then the signal travels down the bundle of His, into the left and right bundle branches, and finally to the Purkinje fibers.

D) SA node → AV node → bundle of His → bundle branches:
This is the correct sequence of the electrical conduction pathway of the heart. The electrical impulse originates at the SA node (the heart's natural pacemaker), then travels to the AV node, where it is delayed to allow the atria to contract and fill the ventricles. From there, the impulse moves down the bundle of His, which splits into the left and right bundle branches, leading to the Purkinje fibers that transmit the impulse throughout the ventricles, causing them to contract. This sequence ensures proper coordination and timing of the heart's contractions.

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Correct Answer is A

Explanation

A) II:
This is the correct answer. The optic nerve (cranial nerve II) is responsible for visual acuity, as it transmits visual information from the retina to the brain. When assessing visual acuity, the nurse is evaluating the function of the optic nerve, which is responsible for the sense of vision. Therefore, cranial nerve II should be assessed during a visual acuity exam.

B) I:
This is incorrect. The olfactory nerve (cranial nerve I) is responsible for the sense of smell, not vision. Visual acuity is not related to the olfactory nerve, so it is not involved in this type of assessment.

C) VI:
This is incorrect. The abducens nerve (cranial nerve VI) controls the lateral rectus muscle of the eye, which is responsible for outward eye movement. While cranial nerve VI plays a role in eye movement, it is not directly involved in measuring visual acuity, which pertains to the function of the optic nerve.

D) IV:
This is incorrect. The trochlear nerve (cranial nerve IV) controls the superior oblique muscle, which helps with eye movement, specifically downward and inward eye movements. This nerve is not involved in measuring visual acuity.

A. Obtain a threat culture for possible streptococcal (strep) infection B. Continue with the assessment, looking for any other abnormal findings C. Refer the client to their primary provider D. No response is needed, this appearance is normal for the tonsils

Correct Answer is D

Explanation

A) Obtain a throat culture for possible streptococcal (strep) infection:
A throat culture for streptococcal infection is generally warranted when there are signs and symptoms of a bacterial infection, such as a sore throat, fever, exudate on the tonsils, or swollen lymph nodes. The description provided—involuted, granular tonsils with deep crypts—is a normal, age-related finding and not indicative of an infection. Therefore, obtaining a throat culture is unnecessary unless additional clinical signs of infection are present.

B) Continue with the assessment, looking for any other abnormal findings:
While it is always important to complete a thorough assessment and look for other abnormal findings, the specific characteristics described (involuted, granular tonsils with deep crypts) are normal, particularly in adults. This is a common finding and does not require further investigation unless accompanied by other symptoms such as pain, swelling, or visible pus, which would warrant a closer look.

C) Refer the client to their primary provider:
Referral to a primary provider is generally recommended if there are significant concerns about the tonsils, such as persistent swelling, pain, or signs of infection. However, the description provided does not suggest a pathological issue; these characteristics are typically considered normal in adults. Referral would only be necessary if additional concerning symptoms were present, such as fever, difficulty swallowing, or changes in voice.

D) No response is needed; this appearance is normal for the tonsils:
This is the correct response. Involuted (shrunken), granular tonsils with deep crypts are a normal, age-related finding, especially in adults. Over time, the tonsils tend to shrink and develop more pronounced crypts (pockets). This is part of the natural aging process and is not usually a sign of pathology. These tonsil changes are often seen in individuals who have had repeated infections or as part of the natural aging process.

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A nurse is reviewing the sequence of the cardiac cycle. The nurse recognizes that the electrical stimulus of the cardiac cycle follows which sequence?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to measure the visual acuity of a client. The nurse should recognize that which nerve should be assessed?

Correct Answer is A

Explanation

A nurse is assessing the tonsils of a client and notes that the tonsils are involuted, granular in appearance, and have deep crypts. The nurse should recognize that which of the following is the correct response to these findings?

Correct Answer is D

Explanation

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