Based on this rhythm strip, which interpretation should the nurse make?
Junctional tachycardia.
Second degree Type II atrioventricular (AV) block (3 to 1).
Ventricular fibrillation.
Atrial flutter.
The Correct Answer is D
A. Junctional tachycardia: Junctional tachycardia originates from the AV node, typically with a narrow QRS, absent or inverted P waves, and a rate of 100–180 bpm. The strip does not show these features.
B. Second-degree Type II AV block (3:1).Type II AV block (Mobitz II) shows dropped QRS complexes with constant PR intervals before conducted beats. This strip does not show missing QRS complexes in a 3:1 pattern.
C. Ventricular fibrillation. VF is characterized by a chaotic, disorganized rhythm with no discernible P waves, QRS complexes, or T waves, completely different from this organized flutter pattern.
D. Atrial flutter is characterized by regular, rapid atrial depolarizations (flutter waves) at a rate of 250–350 bpm. These waves create a "sawtooth" pattern on the ECG.The ventricular response may be regular or irregular, depending on AV conduction. This is different from atrial fibrillation (which has irregularly irregular R-R intervals and no discrete P waves).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["9"]
Explanation
Calculation:
Calculate the dopamine dose in mcg/min:
Dose = 2 mcg/kg/min
Weight = 60 kg
Dose per minute = 2 mcg/kg/min × 60 kg
= 120 mcg/min
Calculate the dopamine dose in mcg/hour:
Dose per hour = 120 mcg/min × 60 min/hour
= 7200 mcg/hour
Convert mcg to mg:
Dose per hour = 7200 mcg/hour / 1000 mcg/mg
= 7.2 mg/hour
Calculate the concentration of dopamine in the IV bag:
Dopamine: 400 mg
Solution: 500 mL
Concentration = 400 mg / 500 mL
= 0.8 mg/mL
Calculate the infusion rate in mL/hour:
Dose per hour: 7.2 mg/hour
Concentration: 0.8 mg/mL
Infusion rate = 7.2 mg/hour / 0.8 mg/mL
= 9 mL/hour
Correct Answer is A
Explanation
A. Normal sinus rhythm (NSR) at 84 beats/minute. The goal of cardioversion for atrial fibrillation (AFib) is to restore a normal sinus rhythm (NSR). NSR indicates that the atria and ventricles are depolarizing in a coordinated manner, reducing the risk of thromboembolism, stroke, and hemodynamic instability. A heart rate of 84 beats/minute is within the normal range, confirming the success of the procedure.
B. Regular rhythm with consistent pacemaker capture. Cardioversion is used to restore normal rhythm in AFib, not to manage pacemaker function. A pacemaker is not part of standard AFib cardioversion unless the client has underlying conduction issues requiring pacing.
C. Return of elevated ST segment to the baseline. ST elevation suggests acute myocardial infarction (MI), which is unrelated to atrial fibrillation or cardioversion. Cardioversion does not treat ST elevation or myocardial ischemia, making this an incorrect indicator of success.
D. Increased frequency of QRS complexes. An increase in QRS frequency suggests tachycardia, which would indicate treatment failure rather than success. The goal of cardioversion is to restore a normal, controlled heart rate and rhythm, not to increase the number of ventricular contractions.
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