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NR 341_NR341 COMPLEX ADULT HEALTH EXAM 1
LATEST REAL EXAM QUESTIONS AND CORRECT
ANSWERS AGRADE COMPLETE
The QT interval is the total time taken for ventricular depolarization and repolarization.
Prolongation of the QT interval:
- decreases the risk of lethal dysrhythmias.
- usually occurs when heart rate increases.
- increases the risk of lethal dysrhythmias.
- can only be measured with irregular rhythms. - ANSWER>>c
- identifies the markers on the ECG paper that indicate a 6-second strip.
- counts the number of large boxes between two consecutive P waves.
- counts the number of small boxes between two consecutive QRS complexes.
- divides the number of complexes in a 6-second strip by 10. - ANSWER>>A
The patient has an irregular heart rhythm. To determine an accurate heart rate, the nurse first:
Six-second method: A quick and easy estimate of heart rate can be accomplished by counting the number of P waves or QRS waves within a 6-second strip to obtain atrial and ventricular heart rates per minute. This is the optimal method for irregular rhythms. Identify the lines above the ECG paper that represent 6 seconds, and count the number of P waves within the lines; then add a zero (multiply by 10) to identify the atrial heart rate estimate for 1 minute. Next, identify the number of QRS waves in the 6-second strip and again add a zero to identify the ventricular rate.The nurse is calculating the rate for a regular rhythm. There are 20 small boxes between each P wave and 20 small boxes between each R wave. What is the ventricular rate? 1 / 4
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- 50 beats/min
- 75 beats/min
- 85 beats/min
- 100 beats/min - ANSWER>>B
The rule of 1500 is used to calculate the exact rate of a regular rhythm. The number of small boxes between the highest points of two consecutive R waves is counted, and that number of small boxes is divided into 1500 to determine the ventricular rate. 1500/20 = 75 beats/min. This method is accurate only if the rhythm is regular The patient is admitted with a fever and rapid heart rate. The patient's temperature is 103° F (39.4° C).The nurse places the patient on a cardiac monitor and finds the patient's atrial and ventricular rates are above 105 beats per minute. P waves are clearly seen and appear normal in configuration. QRS complexes are normal in appearance and 0.08 seconds wide. The rhythm is
regular, and blood pressure is normal. The nurse should focus on providing:
- medications to lower heart rate.
- treatment to lower temperature.
- treatment to lower cardiac output.
- treatment to reduce heart rate. - ANSWER>>B
Sinus tachycardia results when the SA node fires faster than 100 beats per minute. Sinus tachycardia is a normal response to stimulation of the sympathetic nervous system. Sinus tachycardia is also a normal finding in children younger than 6 years. Both atrial and ventricular rates are greater than 100 beats per minute, up to 160 beats per minute, but may be as high as 180 beats per minute. Sinus tachycardia is regular or essentially regular. PR interval is 0.12 to 0.20 seconds. QRS interval is 0.06 to 0.10 seconds. P and QRS waves are consistent in shape. P waves are small and rounded. A P wave precedes every QRS complex, which is then followed by a T wave. 2 / 4
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3 Which of the following is true about a patient diagnosed with sinus arrhythmia?
- The heart rate varies, dependent on vagal tone and respiratory pattern.
- Immediate treatment is essential to prevent death.
- Sinus arrhythmia is not well tolerated by most patients.
- PR and QRS interval measurements are prolonged. - ANSWER>>A
Sinus arrhythmia is a cyclical change in heart rate that is associated with respiration. The heart rate increases slightly during inspiration and slows slightly during exhalation because of changes in vagal tone. The ECG tracing demonstrates an alternating pattern of faster and slower heart rate that changes with the respiratory cycle.The patient is admitted with sinus pauses causing periods of loss of consciousness. The patient is asymptomatic, awake and alert, but fatigued. He answers questions appropriately. When
admitting this patient, the nurse should first:
- prepare the patient for temporary pacemaker insertion.
- prepare the patient for permanent pacemaker insertion.
- assess the patient's medication profile.
- apply transcutaneous pacemaker paddles. - ANSWER>>c
The patient's heart rate is 165 beats per minute. His cardiac monitor shows a rapid rate with narrow QRS complexes. The P waves cannot be seen, but the rhythm is regular. The patient's blood pressure has dropped from 124/62 to 78/30. His skin is cold and diaphoretic and he is
complaining of nausea. The nurse prepares the patient for:
- administration of beta-blockers.
- administration of atropine.
- transcutaneous pacemaker insertion. 3 / 4
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- emergent cardioversion. - ANSWER>>D
- American Association of Critical-Care Nurses
- American Heart Association
- American Nurses Association
- Society of Critical Care Medicine - ANSWER>>a
If an abnormal P wave cannot be visualized on the ECG but the QRS complex is narrow, the term supraventricular tachycardia (SVT) is often used. This is a generic term that describes any tachycardia that is not ventricular in origin; it is also used when the source above the ventricles cannot be identified, usually because the rate is too fast. Treatment is directed at assessing the patient's tolerance of the tachycardia. If the rate is higher than 150 beats per minute and the patient is symptomatic, emergent cardioversion is considered. Cardioversion is the delivery of a synchronized electrical shock to the heart by an external defibrillator.Which of the following professional organizations best supports critical care nursing practice?
The synergy model of practice focuses on:
- allowing unrestricted visiting for the patient 24 hours each day.
- holistic and alternative therapies.
- needs of patients and their families, which drives nursing competency.
- patients' needs for energy and support. - ANSWER>>c
- Advocacy and moral agency in solving ethical issues
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The family of your critically ill patient tells you that they have not spoken with the physician in over 24 hours and they have some questions that they want clarified. During morning rounds, you convey this concern to the attending intensivist and arrange for her to meet with the family at 4:00 PM in the conference room. Which competency of critical care nursing does this represent?