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 D

Explanation

A. Monitor blood pressure – While important, blood pressure changes are not the most sensitive or early indicator of fluid retention in heart failure.
B. Assess radial pulses – Pulse assessment can reflect cardiac output, but it does not directly indicate fluid balance.
C. Monitor bowel movements – Bowel function is not typically affected by fluid balance in heart failure and is not a relevant measure.
D. Monitor weight daily – Daily weight monitoring is the most accurate and early indicator of fluid retention in clients with heart failure. A weight gain of 2–3 pounds in a day or 5 pounds in a week may indicate fluid overload and should be reported to the healthcare provider.

A. Sinus bradycardia B. Ventricular tachycardia C. Normal sinus rhythm D. Sinus tachycardia

Correct Answer is D

Explanation

A. Sinus bradycardia is characterized by a heart rate below 60 beats/min, which is inconsistent with this client’s elevated heart rate of 128.
B. Ventricular tachycardia is a potentially life-threatening rhythm with wide QRS complexes, usually not the immediate expected rhythm without other signs such as hypotension or loss of consciousness.
C. Normal sinus rhythm has a heart rate between 60–100 beats/min; this client’s rate of 128 exceeds that range.
D. Sinus tachycardia is the most likely rhythm, especially in a client who has used cocaine, a stimulant known to increase sympathetic nervous system activity, leading to increased heart rate and elevated blood pressure.

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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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Correct Answer is D

Explanation

Correct Answer is D

Explanation

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