The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip because:

The view of the electrical current changes in relation to the lead placement.

Conduction of the heart differs with lead placement.

Electrocardiogram (ECG) equipment has malfunctioned.

The circadian rhythm has changed.

Answer and Explanation

The Correct Answer is A

A. The view of the electrical current changes in relation to the lead placement – Each ECG lead offers a different angle or view of the heart's electrical activity, so the waveforms in leads I, II, and III naturally look different. This variation helps clinicians assess different parts of the heart.
B. Conduction of the heart differs with lead placement – The heart's electrical conduction system functions independently of lead placement; only the view of the conduction changes.
C. Electrocardiogram (ECG) equipment has malfunctioned – Lead differences are expected and normal; this is not a sign of malfunction.
D. The circadian rhythm has changed – Circadian rhythms affect general physiological patterns but do not cause variation in ECG lead appearance.

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Correct Answer is C

Explanation

A. Diuretics should be taken early in the morning to avoid nocturia, but not at bedtime.
B. A weight gain of 1 kg (2.2 lb) or more in a day or 1.4–2.3 kg (3–5 lb) in a week should be reported; 0.5 kg (1 lb) in a week is not typically concerning.
C. Regular exercise (e.g., at least three times per week) is encouraged in Class I heart failure to promote cardiovascular health and endurance. This is an appropriate and recommended instruction.
D. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) and should be avoided in clients with heart failure as it may cause fluid retention and worsen heart function.

A. High-quality CPR with minimal interruptions B. Cessation at resuscitation attempts after 2 minutes C. Administration of Narcan until an electrical rhythm is obtained D. Continuous defibrillation until an electrical rhythm is obtained

Correct Answer is A

Explanation

A. High-quality CPR with minimal interruptions is the cornerstone of asystole management. Asystole is a non-shockable rhythm, so maintaining perfusion through effective chest compressions and administering appropriate medications (like epinephrine) is essential.
B. Cessation of resuscitation efforts after only 2 minutes is inappropriate; the decision to stop should be based on the clinical scenario and response to interventions over time.
C. Narcan (naloxone) is used for opioid overdose, not for treating asystole unless there is a suspected opioid-related cause—and it does not directly restore electrical cardiac rhythm.
D. Defibrillation is not indicated in asystole, as it is a non-shockable rhythm. Continuous defibrillation is ineffective and inappropriate.

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The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip because:

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Naxlex Comprehensive Predictor Exams

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