The nurse suspects that a client with pancreatitis has developed hypocalcemia.
Which electrocardiogram finding supports the nurse's suspicion?
Prolonged QT interval.
Shortened PR interval.
Peaked T waves.
Elevated ST segment.
The Correct Answer is A
Pancreatitis often leads to electrolyte imbalances, specifically hypocalcemia due to fat necrosis and soap formation. Knowledge of cardiac electrophysiology is required to recognize how low calcium levels (normal 8.5 to 10.5 mg/dL) affect the myocardial action potential.
Choice A rationale
Prolonged QT interval is a classic electrocardiogram finding in hypocalcemia. Low serum calcium slows the movement of calcium into the cardiac cells during the plateau phase, thereby lengthening the duration of ventricular depolarization and repolarization cycles.
Choice B rationale
A shortened PR interval is not associated with hypocalcemia. PR interval changes are more frequently linked to pre-excitation syndromes or inflammatory conditions of the heart, rather than the specific electrolyte shifts seen in acute pancreatic inflammation.
Choice C rationale
Peaked T waves are a hallmark sign of hyperkalemia, not hypocalcemia. In hypocalcemia, the T wave may actually appear flattened or inverted, but the most distinctive and supportive finding remains the elongation of the QT interval.
Choice D rationale
Elevated ST segments are typically indicative of myocardial infarction or pericarditis. While electrolyte imbalances can cause various cardiac changes, ST elevation is not the primary diagnostic indicator used to support a suspicion of clinical hypocalcemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This scenario requires differentiating between various neurological conditions based on the sudden onset of focal deficits and altered mental status. Recognizing the hallmarks of acute ischemia or hemorrhage is vital for ensuring the patient receives rapid, time sensitive reperfusion therapies.
Choice A rationale
Migraines typically present with unilateral throbbing pain, photophobia, and phonophobia, often preceded by an aura. While they can be severe, they do not usually cause acute facial drooping or the profound confusion associated with a cerebrovascular accident.
Choice B rationale
A stroke involves a sudden interruption of blood flow to the brain, causing rapid onset focal neurological deficits. Facial drooping, confusion, and severe headache are classic signs of either ischemic or hemorrhagic events requiring immediate emergency diagnostic imaging.
Choice C rationale
Trigeminal neuralgia is characterized by sudden, brief, and excruciating paroxysmal facial pain along the branches of the fifth cranial nerve. It does not cause confusion, facial drooping, or a generalized severe headache, as it is a sensory nerve disorder.
Choice D rationale
Meningitis involves inflammation of the meninges, typically presenting with fever, nuchal rigidity, and photophobia. While confusion and headache occur, the onset is usually more gradual than a stroke and does not typically include acute focal facial drooping.
Correct Answer is B
Explanation
Understanding the clinical presentation of thermal injuries is necessary to categorize burn depth accurately. This requires knowledge of integumentary layers, including the epidermis, dermis, and subcutaneous tissues, and how specific visual markers like eschar or mottling reflect the level of tissue destruction.
Choice A rationale
First degree burns, or superficial burns, involve only the epidermis. They are characterized by redness, pain, and mild edema without blistering or eschar. The skin remains intact and dry, unlike the mottled red skin and edema seen here.
Choice B rationale
Deep partial thickness burns extend into the deeper layers of the dermis. Findings include a mottled red appearance, moderate edema, and soft, dry eschar. These wounds take longer to heal and usually require surgical intervention for optimal recovery.
Choice C rationale
Superficial partial thickness burns involve the epidermis and upper dermis. They typically present with pink, moist skin and blister formation. The presence of soft eschar and mottled red skin indicates a deeper injury than what is characteristic here.
Choice D rationale
Full thickness burns involve the entire dermis and may reach subcutaneous fat or muscle. The skin appears waxy white, leathery, or charred. While eschar is present, it is usually hard and inelastic rather than soft and mottled.
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