The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?
2nd degree Mobitz Il
Atrial flutter
Sinus bradycardia
1st degree AV block
The Correct Answer is D
A. This type of AV block is characterized by a progressively lengthening PR interval until a QRS complex is dropped (a blocked beat). A PR interval of 0.28 seconds could be seen in 2nd degree Mobitz I (Wenckebach), not Mobitz II, which has a more irregular pattern of dropped beats
B. Atrial flutter: Atrial flutter is a type of arrhythmia characterized by rapid atrial rates (typically around 250-350 beats per minute) with a sawtooth pattern of P-waves. It does not relate to the PR interval, but rather the atrial rhythm.
C. Sinus bradycardia: Sinus bradycardia is characterized by a slower-than-normal heart rate (less than 60 beats per minute), but this does not affect the PR interval directly. A normal PR interval (0.12-0.20 seconds) can still be seen in sinus bradycardia, so the prolonged PR interval in this case makes sinus bradycardia less likely.
D. 1st degree AV block: In 1st degree AV block, the PR interval is consistently prolonged, usually more than 0.20 seconds, but it is still a constant, non-variable delay in the conduction between the atria and ventricles. A PR interval of 0.28 seconds (which is longer than normal but consistent) is characteristic of a first-degree AV block, making it the correct answer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Increased risk for cardiac dysrhythmias: While hyponatremia can sometimes contribute to cardiac dysrhythmias, it's not the primary concern in this case. The main issue is fluid overload.
B. Hyponatremia, or low sodium levels, is often associated with heart failure. In this condition, the heart's reduced pumping ability leads to fluid retention, which dilutes the sodium concentration in the blood.
C. Imbalance in the sodium-potassium pump: While this can contribute to electrolyte imbalances, it's not the direct cause of hyponatremia in heart failure.
D. Acute renal failure: While heart failure can lead to acute kidney injury, hyponatremia is primarily a result of fluid overload rather than kidney dysfunction.
Correct Answer is D
Explanation
A. A value of 119 seconds would indicate a therapeutic or even elevated level of heparin, as it is much higher than the normal aPTT range.
B. A value of 98 seconds is still above the normal aPTT range, suggesting that the heparin level is therapeutic, or even too high, but not sub-therapeutic.
C. This is just slightly above the normal range and might be considered a therapeutic range for someone
on heparin, but it’s not sub-therapeutic.
D. This aPTT value is above the normal range but likely not high enough to indicate therapeutic heparin levels, which should typically be between 1.5 to 2.5 times the normal aPTT. A sub-therapeutic level could be indicated with a lower value.
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