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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. surgery has caused an episode of supraventricular tachycardia: While stress or surgery can trigger arrhythmias, the ECG shown demonstrates a sinus tachycardia pattern (narrow QRS complexes with identifiable P waves before each QRS), not supraventricular tachycardia (SVT), which typically has a very rapid, regular rhythm often without visible P waves.
B. is febrile which is causing the heart rate to be elevated: The client has a temperature of 102°F (38.8°C), which can increase metabolic demand and lead to sinus tachycardia. Fever is a common and expected cause of elevated heart rate, especially when accompanied by infection, such as the client’s post-op wound infection.
C. is in heart failure and the heart rate is elevated to compensate: There is no evidence from the scenario (no dyspnea, crackles, edema, or reduced BP) that supports heart failure. The elevated HR is more directly related to the fever and infection, not cardiac decompensation.
D. probably has a low oxygen saturation causing an increased respiratory rate: The respiratory rate is slightly elevated (22/min), but there is no mention of hypoxia or oxygen saturation levels. Tachycardia secondary to hypoxia would require clinical indicators of respiratory distress or desaturation, which are not demonstrated.
Correct Answer is C
Explanation
A. Administer an antidiarrheal medication: Atropine is an anticholinergic agent that reduces gastrointestinal motility, often leading to constipation rather than diarrhea. Administering an antidiarrheal would not be appropriate and could cause harmful effects if unnecessary.
B. Assess the pupils for constriction: Atropine causes pupil dilation (mydriasis), not constriction. Checking for constriction would not align with the expected pharmacologic effects of the drug and is not a priority assessment after administration.
C. Provide frequent oral care: Atropine inhibits secretions as part of its anticholinergic effects, often leading to dry mouth (xerostomia). Frequent oral care helps maintain mucous membrane integrity and client comfort, making this an appropriate nursing action following administration.
D. Insert an indwelling catheter: Although atropine can cause urinary retention, especially in older adults, catheter insertion is not routinely required after administration; a single 0.5 mg IV dose is less likely to cause significant urinary retention requiring catheterization. It should only be considered if the client shows clinical signs of acute urinary retention.
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