NR-324 Adult Health I - Set 3 - Part 3

Correct Answer: The atria and ventricles are beating independently

Two independent, regular rates with a PR interval that never repeats means complete atrioventricular dissociation. The atria follow the sinoatrial node while an escape pacemaker below the block drives the ventricles, which defines third degree block. Option a is incorrect because a fixed conduction ratio produces a constant PR interval on the beats that do conduct. Here no P wave bears any timing relationship to the complex that follows it. Option b is incorrect because nodal delay alone lengthens the PR interval while keeping it identical on each beat, which is first degree block. Nothing is conducting through to the ventricles in this strip. Option c is incorrect because regular P waves at eighty per minute prove the sinoatrial node is firing normally. The failure lies between the atria and the ventricles, not in the pacemaker itself.

Correct Answer: This edema reflects vasodilation and resists diuretics

Dihydropyridine edema results from arteriolar dilation raising capillary hydrostatic pressure locally, pushing fluid into the interstitium. It is not fluid overload, so diuretics do not help, and a dose reduction or an added ARB does. Option b is incorrect because heart failure would bring dyspnea, crackles, jugular venous distention and weight gain, and none of those are present. Ankle swelling alone does not establish a failing ventricle. Option c is incorrect because a true sodium and water excess would show as a rising daily weight and generalized congestion. The stable weight here argues against any gain in total body fluid. Option d is incorrect because the swelling is dose related, so raising the amount would worsen it rather than relieve it. Providers usually lower the dose or pair the drug with an agent that dilates veins.

Correct Answer: Assisting a dizzy client to stand slowly

Assistive personnel may help a client change position slowly and ambulate safely, which is a standard supportive task. Teaching, assessment and evaluation of a drug response all require nursing judgment and stay with the nurse. Option a is incorrect because client education requires the nurse to assess readiness, tailor content and check understanding. Handing a diet plan to unlicensed staff cannot accomplish any of those steps. Option b is incorrect because a first assessment of pulse quality on an unfamiliar client establishes the baseline everything else is compared against. Grading and interpreting a pulse is a nursing responsibility. Option c is incorrect because judging whether a medication worked is the evaluation step of the nursing process. Assistive personnel may report a number, but deciding what that number means belongs to the nurse.

Correct Answer: First degree atrioventricular block

Every P wave conducts, so the P to QRS ratio stays one to one, but the PR interval exceeds 0.20 second and is identical on each beat. That combination defines first degree block. Option b is incorrect because Wenckebach requires the PR interval to lengthen beat by beat until a QRS is dropped. Here the interval never changes and no complex is missing. Option c is incorrect because complete block shows no relationship at all between P waves and QRS complexes. This strip has a fixed PR interval, which proves the atria and ventricles are still linked. Option d is incorrect because a normal PR interval falls between 0.12 and 0.20 second. A wandering pacemaker also produces P waves that change shape from beat to beat, which is not described.

Correct Answer: Draw the blood cultures before the antibiotic starts

Fever with a new regurgitant murmur is infective endocarditis until proven otherwise. Antibiotics given first can sterilize the sample and leave the organism unidentified, so at least two sets of cultures are drawn beforehand. Option a is incorrect because the order of these two tasks decides whether the organism is ever named. Once the drug circulates, cultures may grow nothing, and therapy for weeks is then chosen blind. Option c is incorrect because imaging confirms the vegetation but delays both prescribed orders. Echocardiography follows the cultures rather than replacing them, and it identifies no organism to guide the antibiotic choice. Option d is incorrect because lowering the temperature treats a symptom and ignores the reason for it. A febrile client with a fresh murmur needs the infection identified, not a comfort measure repeated every hour.

Correct Answer: I will stop the water pill once the swelling goes away.

The diuretic prevents the fluid from returning, so feeling better is the drug working rather than the disease resolving. Stopping it once the swelling settles is the commonest reason these clients are readmitted. Option a is incorrect because this describes correct technique. Weighing at the same time each morning before eating, after voiding and on the same scale gives a trend that reflects fluid rather than food. Option b is incorrect because a gain of two or more pounds in one day is exactly the threshold this course teaches clients to report. Recognizing it shows the teaching has been understood. Option d is incorrect because most dietary sodium hides in processed foods such as canned soup rather than in the salt shaker. Label reading is precisely the skill that keeps intake under two grams daily.

Correct Answer: Hypertension stage two

Stage one and stage two are assigned with or logic, so either number alone can stage the client. A diastolic of ninety four meets the stage two threshold, and the higher category always governs. Option a is incorrect because elevated blood pressure requires a systolic between one hundred twenty and one hundred twenty nine together with a diastolic under eighty. Both of this client's numbers exceed those limits. Option b is incorrect because a normal classification demands a systolic under one hundred twenty and a diastolic under eighty. Telling this client the pressure is normal would delay treatment of established disease. Option c is incorrect because the systolic of one hundred thirty two does sit in the stage one band, but the diastolic has already crossed ninety. Reading only the top number underestimates the client's true category.

Correct Answer: Continue to monitor and document the finding

Sinus bradycardia in a conditioned athlete is a normal finding produced by high vagal tone and a large stroke volume. With no symptoms of poor perfusion, monitoring and documentation are the appropriate actions. Option b is incorrect because atropine treats bradycardia that is producing symptoms such as hypotension, syncope, angina or confusion. Raising the rate in a well perfused athlete offers no benefit and may cause tachycardia. Option c is incorrect because pacing is reserved for symptomatic bradycardia that has not responded to drugs, or for high grade block. Standby equipment is not warranted for a healthy resting rate of fifty. Option d is incorrect because fluid restriction has no effect on sinoatrial node firing and is not part of bradycardia care. Preoperative fasting orders come from the surgical plan, not from the heart rate.

Correct Answer: I will stop the pills when my pressure normalizes.

Blood pressure that has normalized on therapy is normal because of the therapy. Hypertension is lifelong and asymptomatic, so stopping the drugs allows the pressure to climb again without producing any warning symptom. Option a is incorrect because keeping a home log and bringing it to appointments is exactly what guides dose adjustment. This statement shows the client has understood the monitoring plan correctly. Option b is incorrect because reporting a side effect rather than quietly quitting gives the provider a chance to substitute another agent. Almost every adverse effect in these classes has a workable alternative. Option d is incorrect because morning dosing of a diuretic keeps the diuresis from interrupting sleep during the night. The client has described the recommended timing, so no correction is needed here.

Correct Answer: Count every QRS in six seconds, multiply by ten

Absent P waves with widely varying R to R intervals describe atrial fibrillation. The six second method averages across many beats, which makes it the only defensible rate calculation when the rhythm is irregular. Option a is incorrect because the big box method extrapolates from a single R to R interval. In an irregular rhythm adjacent pairs differ, so the reported rate changes with whichever pair is measured. Option c is incorrect because the fifteen hundred method offers finer precision but still rests on one measured cycle. Precision does not help when the cycles themselves are unequal, as they are here. Option d is incorrect because flutter waves belong to atrial flutter, which shows a uniform sawtooth baseline rather than chaotic fibrillatory waves. Counting atrial waves also reports the atrial rate, not the ventricular one.