The client arrives to the emergency department with syncope. After placing the telemetry monitor on the client, the nurse sees this rhythm. How should the nurse interpret this rhythm?

Complete (third-degree) heart block

Pacemaker rhythm

Sinus bradycardia

First-degree heart block

Answer and Explanation

The Correct Answer is B

A. Complete (third-degree) heart block: This rhythm is characterized by a lack of relationship between P waves and QRS complexes, indicating a complete dissociation between atrial and ventricular activity.

B. A pacemaker rhythm on an ECG is characterized by the presence of pacing spikes followed by P waves or QRS complexes, depending on whether the pacemaker is pacing the atrium or the ventricle. If the pacemaker is pacing the ventricle, the pacing spike will be followed by a QRS complex. The QRS complexes in a paced rhythm are often wider than normal.

C. Sinus bradycardia: Sinus bradycardia is a slow but regular rhythm originating from the sinus node, with normal P waves and QRS complexes.

D. First-degree heart block: First-degree heart block is characterized by a prolonged PR interval (greater than 0.20 seconds) but with all P waves followed by QRS complexes, differing from third-degree heart block.

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Correct Answer is A

Explanation

A. It indicates a normal depolarization of the atria: A PR interval of 0.12–0.20 seconds is within the normal range, representing normal conduction through the atria and AV node.

B. It provides information about atrial repolarization: Atrial repolarization is obscured by the QRS complex and not reflected in the PR interval.

C. It shows an early indication of first-degree heart block: First-degree heart block is indicated by a PR interval longer than 0.20 seconds.

D. It reflects a delayed conduction through the atria: A delay in conduction would result in a prolonged PR interval.

A. The client's blood pressure has decreased since the last visit B. The client's liver is enlarged and the abdomen is edematous C. The client has jugular vein distention and 3+ pedal edema D. The client complains of shortness of breath when walking

Correct Answer is D

Explanation

A. The client's blood pressure has decreased since the last visit. Decreased blood pressure is not a typical early sign of mitral valve stenosis.

B. The client's liver is enlarged and the abdomen is edematous. These are signs of more advanced heart failure, which can result from mitral valve stenosis but are not early indicators.

C. The client has jugular vein distention and 3+ pedal edema. Jugular vein distention and pedal edema are later signs of heart failure caused by mitral valve stenosis, not early signs.

D. The client complains of shortness of breath when walking. Shortness of breath on exertion is an early sign of mitral valve stenosis as the left atrium is unable to effectively pump blood into the left ventricle, leading to pulmonary congestion and difficulty breathing.

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The client arrives to the emergency department with syncope. After placing the telemetry monitor on the client, the nurse sees this rhythm. How should the nurse interpret this rhythm?

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Naxlex Comprehensive Predictor Exams

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