HESI:l NSG223/l NSGl 223l (Latestl 2025/l
2026l Update)l Medical-Surgicall Nursingl IIl Review|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l Herzing
Q:l Whatl isl thel QRSl complex?
Answer:
ventricularl depolarizationl andl atriall repolarizationl (atrial relaxationl isl hiddenl byl ventriclel contraction)
Depolarizationl =l heartl contractsl Repolarizationl =l relax
Q:l Tl wavel represents
Answer:
ventricularl repolarizationl (relaxing)
Concurrentl withl endl ofl ventricularl systole
Mayl becomel tentedl (peaked)l inl hyperkalemia
Q:l pacemakerl instructions
Answer:
Al newl pacemakerl requiresl limitationl ofl physicall activity,l includingl nol lifting,l pulling,l orl pushingl morel thanl 5l pounds.l 1 / 3
Otherl limitationsl includel limitingl tasksl likel sweepingl inl repetitivel motions,l keepingl thel areal freel froml pressurel (suchl asl tightl clothingl orl suspenders),l andl notl raisingl thel arml onl thel affectedl sidel abovel thel levell ofl thel heartl forl thel firstl fewl weeks.l
Thel pacemakerl insertionl sitel mayl bel bruised,l swollen,l tender,l andl instructionsl mayl includel gentlel washingl ofl incisionl site,l andl notl applyingl lotionl orl powder.
pacemakerl isl oftenl implantedl tol treatl symptomaticl bradycardia,l whichl mayl occurl oml al numberl ofl differentl pathophysiologicall conditions.l Thesel includel second-agreel AVl blockl typel Il,l third-degreel AVl block,l andl sickl sinusl syndrome.
Q:l normall sinusl rhythm
Answer:
Electricall conductionl thatl beginsl inl thel SAl nodel generatesl al sinusl rhythm.l Normall sinusl rhythml occursl whenl thel electricall impulsel startsl atl al regularl ratel andl rhythml inl thel SAl nodel andl travelsl throughl thel normall conductionl pathway.l
Normall sinusl rhythml hasl thel followingl characteristics:
•l Ventricularl andl atriall rate:l 60l tol 100l bpml inl thel adult
•l Ventricularl andl atriall rhythm:l Regular
•l QRSl shapel andl duration:l Usuallyl normal,l butl mayl bel regularlyl abnormal
•l Pl wave:l Normall andl consistentl shape;l alwaysl inl frontl ofl thel QRS
•l PRl interval:Consistentl intervall betweenl 0.12l andl 0.20l seconds
•l P:QRSl ratio:
Q:l prematurel ventricularl contractionl (PVC)
Answer:
earlyl contractionl ofl thel ventricles,l nol pl wave
Potassiuml levelsl shouldl bel evaluatedl sincel hypokalemial mayl causel pvca.l Thel personl withl pvcl feelsl asl thoughl theirl heartl skippedl al beatl
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Evenl thoughl anl occasionall PVCl isl notl generallyl concerning,l lifestylel changesl canl helpl decreasel orl eliminatel theirl occurrence.l Decreasingl stressl andl caffeinel arel al couplel changesl whichl canl significantlyl decreasel PVCs.
Q:l Ventricularl fibrillationl (V-fib)
Answer:
Ventricularl fibrillationl isl al rapid,l disorganizedl ventricularl rhythml thatl causesl ineffectivel quiveringl ofl thel ventricles.
clientsl mayl becomel unresponsive,l withoutl al pulse,l andl mayl stopl breathing.l CPRl mustl bel initiatedl immediately.l Thel priorityl isl tol ministerl al shockl immediately.
Ventricularl fibrillationl andl pulselessl ventricularl tachycardial arel lifel threateningl dyshythmias.l Immediatel actionl (immediatel CPRl andl defibrillation)l isl requiredl tol keepl thisl clientl alive.
Q:l Torsadel del points
Answer:
Tororsadel del pointesl (Frenchl meaningl "wistingl ofl thel peaks"l isl al typel ofl ventricular tachycardial (VT).l
Thisl polymorphicl VTl isl characterizedl byl longl QTl intervalsl andl irregularl QRSl complexesl thatl seeml tol bel twistingl aroundl thel ECGl baseline,l isoelectricl line.l Duel tol thisl twistingl aroundl thel ECGl baseline,l itl isl alsol calledl "twistingl ofl thel point".l Thisl dangerousl rhythml mayl precipitatel ventricularl fibrillation,l al deadlyl arrhythmia.l
Alcoholl abusel canl bel associatedl withl thisl occurrence.l Also,l hypomagnesaemial andl hypokalemial canl causel thisl dyshythmial therefore,l carefull monitoringl ofl thesel electrolytesl willl helpl preventl thisl arrhythmia.l
Thel nursel shouldl anticipatel ordersl froml thel healthcarel providerl tol administerl anl IVl infusionl ofl magnesiuml andl potassium.l Thel nursel shouldl alsol monitorl andl anticipatel treatmentl forl deliriuml tremensl (DTs).
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