The nurse identifies the following rhythm on the cardiac monitor. Which treatment modality will the nurse anticipate for this client?
Radiofrequency ablation
Administration of amiodarone
insertion of a pacemaker
Administration of adenosine
The Correct Answer is C
A. Radiofrequency ablation: This is used to treat tachyarrhythmias such as atrial fibrillation, atrial flutter, or supraventricular tachycardia (SVT). The ECG shown does not demonstrate any tachycardic rhythm rather, it shows a bradyarrhythmia with dropped QRS complexes, which suggests a conduction block, not a reentrant circuit.
B. Administration of amiodarone: Amiodarone is primarily used for ventricular arrhythmias or atrial fibrillation. It is not effective in treating bradyarrhythmias or heart blocks such as those seen in this rhythm strip.
C. Insertion of a pacemaker: The rhythm strip shows intermittent dropped QRS complexes with consistent P waves—this is indicative of second-degree AV block, Mobitz II. This type of conduction block can progress to complete heart block and is often treated with the insertion of a permanent pacemaker to maintain cardiac output.
D. Administration of adenosine: Adenosine is used to terminate SVT by temporarily blocking AV node conduction. It is contraindicated in heart blocks, especially Mobitz II or third-degree AV block, because it can worsen the block and cause asystole.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dilated: Peripartum cardiomyopathy is a form of dilated cardiomyopathy that can occur during the last month of pregnancy or within five months after delivery. It is characterized by ventricular dilation and impaired systolic function, leading to signs of heart failure in previously healthy women.
B. Restrictive: Restrictive cardiomyopathy is a rare form that involves impaired ventricular filling due to stiffened myocardial walls. It is typically associated with infiltrative diseases like amyloidosis or sarcoidosis, not with pregnancy or the postpartum period.
C. Hypertrophic: Hypertrophic cardiomyopathy is usually genetic and involves thickened ventricular walls, especially the interventricular septum. It is not linked to childbirth and tends to present earlier in life with symptoms like syncope or sudden cardiac death in young athletes.
D. Myocarditis: Myocarditis involves inflammation of the heart muscle due to infection or autoimmune causes. Although it can occur postpartum, it is not specifically associated with childbirth like peripartum cardiomyopathy, which is a distinct clinical entity.
Correct Answer is B
Explanation
A. surgery has caused an episode of supraventricular tachycardia: While stress or surgery can trigger arrhythmias, the ECG shown demonstrates a sinus tachycardia pattern (narrow QRS complexes with identifiable P waves before each QRS), not supraventricular tachycardia (SVT), which typically has a very rapid, regular rhythm often without visible P waves.
B. is febrile which is causing the heart rate to be elevated: The client has a temperature of 102°F (38.8°C), which can increase metabolic demand and lead to sinus tachycardia. Fever is a common and expected cause of elevated heart rate, especially when accompanied by infection, such as the client’s post-op wound infection.
C. is in heart failure and the heart rate is elevated to compensate: There is no evidence from the scenario (no dyspnea, crackles, edema, or reduced BP) that supports heart failure. The elevated HR is more directly related to the fever and infection, not cardiac decompensation.
D. probably has a low oxygen saturation causing an increased respiratory rate: The respiratory rate is slightly elevated (22/min), but there is no mention of hypoxia or oxygen saturation levels. Tachycardia secondary to hypoxia would require clinical indicators of respiratory distress or desaturation, which are not demonstrated.
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