Identify the following rhythm:
Atrial Fibrillation
Ventricular tachycardia
Ventricular Fibrillation
Premature Ventricular Contractions
The Correct Answer is C
Atrial fibrillation (AF) is characterized by disorganized electrical activity in the atria, resulting in an irregular and often rapid heart rate.
On an ECG, AF typically presents with absent P waves, irregular R-R intervals, and a rapid ventricular rate (usually >100 beats per minute).
However, the rhythm in the question does not display these characteristic features of AF.
Key features of AF that are absent in the rhythm include:
P waves: AF lacks identifiable P waves, while the rhythm in question may have discernible P waves, although they may be irregular or abnormal.
Regularity: AF is typically irregular, while the rhythm in question is chaotic and without any discernible pattern.
QRS complexes: AF usually has narrow QRS complexes, while the rhythm in question often has wide and bizarre QRS complexes. Choice B rationale:
Ventricular tachycardia (VT) is a rapid heart rhythm originating from the ventricles, with a rate typically exceeding 100 beats per minute.
On an ECG, VT typically presents with wide QRS complexes (>0.12 seconds), a regular or slightly irregular rhythm, and a rate often exceeding 150 beats per minute.
While the rhythm in question is rapid and may have wide QRS complexes, it lacks the regular or slightly irregular pattern often seen in VT.
Key features of VT that distinguish it from the rhythm in question include:
Regularity: VT often has a regular or slightly irregular pattern, while the rhythm in question is chaotic and without any discernible pattern.
QRS morphology: VT typically has monomorphic (uniform) QRS complexes, while the rhythm in question often has polymorphic (varying) QRS complexes.
Choice D rationale:
Premature ventricular contractions (PVCs) are extra heartbeats originating from the ventricles, interrupting the normal heart rhythm.
On an ECG, PVCs appear as early, wide QRS complexes that are often followed by a compensatory pause.
The rhythm in question does not exhibit the characteristic pattern of PVCs, which typically occur as isolated beats or short runs of beats interspersed within a normal rhythm.
Key features of PVCs that are absent in the rhythm include:
Isolation: PVCs typically occur as isolated beats or short runs of beats, while the rhythm in question is sustained and chaotic.
Compensatory pause: PVCs are often followed by a compensatory pause, which is not a feature of the rhythm in question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale:
Duration of pain: Stable angina typically lasts for less than 5 minutes, while pain from a myocardial infarction (MI) typically lasts longer, often 20 minutes or more. This is because stable angina is caused by a temporary decrease in blood flow to the heart muscle, while an MI is caused by a complete blockage of blood flow, leading to more severe and prolonged pain.
Mechanism of pain: The pain in stable angina is due to ischemia, which is a lack of oxygen to the heart muscle. This occurs when the demand for oxygen by the heart muscle exceeds the supply of oxygenated blood.
Nitrates and ischemia: Nitrates, such as nitroglycerin, work by dilating the coronary arteries, which increases blood flow to the heart muscle and relieves ischemia. This is why nitroglycerin is often effective in relieving the pain of stable angina.
Choice B rationale:
Non-specific symptom: Shortness of breath can occur with both stable angina and MI, as well as other conditions such as lung disease or anxiety. Therefore, it is not a specific symptom that can be used to differentiate between the two conditions.
Choice C rationale:
Activity level: Stable angina is typically triggered by exertion or emotional stress, which increase the heart's demand for oxygen.
Rest and angina: The pain often subsides with rest or nitroglycerin.
MI and rest: In contrast, the pain of an MI can occur at rest and is not always relieved by nitroglycerin.
Choice D rationale:
Nitrates and stable angina: As mentioned earlier, nitrates are often effective in relieving the pain of stable angina.
Nitrates and MI: However, they may not be as effective in relieving the pain of an MI, as the blockage of blood flow is more severe.
Correct Answer is C
Explanation
Choice A rationale:
Drowsiness and blurred vision are not common adverse effects of nitroglycerin.
While some individuals may experience mild drowsiness, it's not a primary concern.
Blurred vision is not typically associated with nitroglycerin use.
Choice B rationale:
Nervousness and paresthesia (tingling or numbness in the extremities) are not common adverse effects of nitroglycerin.
Some individuals may experience transient anxiety or nervousness, but it's not a characteristic side effect.
Paresthesia is more commonly associated with other medications or conditions.
Choice C rationale:
Throbbing headache and dizziness are the most common adverse effects of nitroglycerin.
They occur due to nitroglycerin's vasodilatory effect, which causes blood vessels to relax and widen.
This can lead to a temporary drop in blood pressure, resulting in headaches and dizziness.
The headaches are often described as throbbing or pulsating, and they typically occur in the frontal or temporal regions of the head.
Dizziness may be mild or severe, and it may be accompanied by lightheadedness or a feeling of unsteadiness.
Choice D rationale:
Tinnitus (ringing in the ears) and diplopia (double vision) are not common adverse effects of nitroglycerin.
They may occur in rare cases, but they are not typically associated with its use.
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