The nurse understands that sinus tachycardia differs from normal sinus rhythm because:

the heart rate is greater than 100 bpm in sinus tachycardia

more p waves are present than QRS complexes

the QRS complexes measure greater than 0.10

the rhythm is often irregular in sinus tachycardia

Answer and Explanation

The Correct Answer is A

A. the heart rate is greater than 100 bpm in sinus tachycardia: Normal Sinus Rhythm is characterized by a heart rate between 60 and 100 beats per minute (bpm). Sinus tachycardia is defined as a sinus rhythm with a heart rate exceeding 100 beats per minute. The rhythm remains regular, with each P wave followed by a QRS complex, but the rate is significantly faster than normal sinus rhythm.

B. more p waves are present than QRS complexes: In sinus tachycardia, the number of P waves and QRS complexes remains one-to-one, as each atrial impulse continues to be conducted to the ventricles. More P waves than QRS complexes typically suggest atrial flutter or other forms of AV dissociation.

C. the QRS complexes measure greater than 0.10: A widened QRS complex suggests a bundle branch block or ventricular rhythm, not sinus tachycardia. In sinus tachycardia, QRS complexes typically remain narrow, measuring less than 0.10 seconds unless an intraventricular conduction delay is present.

D. the rhythm is often irregular in sinus tachycardia: Sinus tachycardia is usually a regular rhythm with consistent R-R intervals. An irregular rhythm is more indicative of atrial fibrillation or sinus arrhythmia, not a defining characteristic of sinus tachycardia.

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Correct Answer is ["A","B","D","E"]

Explanation

A. The P-P and R-R distances are equal and regular: Equal and regular spacing between P-P and R-R intervals indicates that both atrial and ventricular rhythms are regular. This is a fundamental aspect of rhythm interpretation, helping to distinguish between regular and irregular rhythms such as atrial fibrillation or sinus arrhythmia.

B. The rhythm rate using a 3-second strip: Assessing the heart rate using a 3-second or 6-second ECG strip helps determine whether the rhythm is bradycardic, tachycardic, or within normal limits, which is crucial for accurate rhythm classification.

C. The duration of the U waves: U waves are typically small and follow the T wave. Although their presence can suggest conditions like hypokalemia, they are not routinely assessed in basic rhythm identification. Evaluating U wave duration is more relevant in electrolyte imbalance analysis than in identifying rhythm type.

D. There is a QRS complex after each P wave: A consistent QRS following every P wave indicates effective conduction from the atria to the ventricles. Each atrial depolarization (P wave) should be followed by a ventricular depolarization (QRS complex) if the signal is being conducted properly through the AV node. This finding supports a diagnosis of sinus rhythm and helps rule out AV blocks, where conduction may be delayed or blocked entirely.

E. P waves are present, upright and rounded: P waves that are upright and rounded in lead II suggest the electrical impulse is originating from the SA node. Their presence and morphology are essential criteria for identifying sinus rhythm and differentiating it from atrial arrhythmias like flutter or fibrillation.

A. Prepare the client for electrical cardioversion B. Perform a carotid massage on the client. C. Administer lidocaine 1mg/hour. D. Ask the client if they drank a caffeinated beverage

Correct Answer is B

Explanation

A. Prepare the client for electrical cardioversion: Electrical cardioversion is reserved for unstable patients (e.g., hypotension, altered mental status, chest pain, or signs of shock). This client, while tachycardic, has a blood pressure of 106/60, which indicates relative stability. Cardioversion is not the first-line intervention in stable supraventricular tachycardia (SVT).

B. Perform a carotid massage on the client: Carotid sinus massage is a vagal maneuver used to slow conduction through the AV node and can terminate paroxysmal supraventricular tachycardia (PSVT). It is a non-invasive, first-line intervention for a stable patient with narrow-complex tachycardia, as shown on the ECG strip.

C. Administer lidocaine 1 mg/hour: Lidocaine is an antiarrhythmic used primarily to treat ventricular arrhythmias, such as ventricular tachycardia or fibrillation. It is not indicated for atrial or supraventricular tachycardias and would not address the underlying rhythm.

D. Ask the client if they drank a caffeinated beverage: While excessive caffeine intake can contribute to tachycardia, asking about caffeine use does not address the acute arrhythmia or guide immediate treatment. It may be part of history-taking but is not a priority intervention in this situation.

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Potassium 2.8 mEq/L
Sodium 133 mEq/L
Chloride 90 mEq/L
Glucose 200 mg/dl
Magnesium 2.5 mg/dL
Calcium 8.0 mg/dL

The nurse understands that sinus tachycardia differs from normal sinus rhythm because:

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Naxlex Comprehensive Predictor Exams

To properly identify a cardiac rhythm, the nurse will determine if the client's rhythm contains the following factors: (Select All that Apply.)

Correct Answer is ["A","B","D","E"]

Explanation

Rhythm Strip A client comes to the emergency department (ED) complaining of a "racing heart and nervousness." The client's blood pressure is 106/60. The cardiac monitor displays the rhythm below. Which nursing action should be performed first?

Correct Answer is B

Explanation

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