PCCN practice exam notes Graded A+

Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ lvl is 3.4. What action would you do first? a. emergent defib b. amio 300mg IVP c. emergent cardioversion d. hang 10 mEq KCL/50mL D5W - Answer C The nurse notes the following when analyzing a patient's telemetry strip: HR, 65/min and regular; PR interval, 0.22 seconds; QRS complex, 0.10 seconds; QTc, 0.52 seconds. Which of the following dysrhythmias is the patient at risk for? A. Atrial fibrillation because the PR interval is wide B. Sinus arrhythmia because the QRS complex is narrow C. Torsades de pointes because the QTc is wide D. Third-degree heart block because the PR interval is narrow - Answer C. QT measurements reflect the duration of ventricular repolarization. Lengthening of QT interval is associated with arrhythmias, adverse cardiac events, and increased mortality because a longer QT duration places the vulnerable ventricular repolarization phase close to the next depolarization, increasing the likelihood of R-on-T. The most common arrhythmia that occurs with prolonged QTc is torsades de pointes. Atrial fibrillation, sinus bradycardia, and third-degree heart block are not typically associated with prolonged ventricular repolarization (QTc >0.50 seconds). A patient with chronic obstructive pulmonary disease (COPD) is admitted for worsening dyspnea and possible pneumonia. The current ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3 - , 32 mmol/L. The nurse would interpret these results as A. Metabolic acidosis with hypoxemia B. Respiratory acidosis with hypoxemia C. Respiratory alkalosis with typical oxygenation for a COPD patient D. Metabolic alkalosis with typical oxygenation for a COPD patient - Answer B.