The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, QRS complex wide and QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as
ventricular tachycardia.
ventricular fibrillation.
sinus tachycardia.
atrial flutter.
The Correct Answer is A
A. Ventricular tachycardia is characterized by a ventricular rate >100 bpm, regular rhythm, no visible P waves, and wide QRS complexes (>0.12 seconds). The findings described—ventricular rate of 162, regular R-R intervals, no visible P waves, and a QRS duration of 0.18 seconds—are consistent with ventricular tachycardia.
B. Ventricular fibrillation shows a chaotic, irregular rhythm with no identifiable QRS complexes, which is not the case here.
C. Sinus tachycardia would have visible P waves and a normal QRS duration.
D. Atrial flutter typically has "sawtooth" flutter waves and a more organized atrial rhythm with a distinct P wave pattern, which is absent in this scenario.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Splinter hemorrhages are a common sign of infective endocarditis but are not immediately life-threatening.
B. Fever is a typical manifestation of infection and expected in infective endocarditis, not a priority unless unresponsive to treatment.
C. Clusters of petechiae in the mouth indicate microemboli or vascular involvement, but they are not an acute threat.
D. Dyspnea is the priority finding because it may indicate heart failure or pulmonary embolism, both of which are serious complications of infective endocarditis and require immediate intervention.
Correct Answer is A
Explanation
A. An echocardiogram is the most helpful noninvasive tool for diagnosing cardiomyopathy. It provides detailed information about chamber size, wall motion, ventricular function, and left ventricular hypertrophy, all of which are essential in evaluating cardiomyopathy.
B. Arterial blood gases (ABGs) assess oxygenation and acid-base balance but do not provide structural or functional cardiac details.
C. Swan-Ganz analysis (pulmonary artery catheter) can measure pressures in the heart but is invasive and typically used for hemodynamic monitoring, not initial diagnosis.
D. Cardiac catheterization can show coronary anatomy and pressures, but it is not the first-line test for evaluating cardiomyopathy unless ischemic disease is suspected.
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