Next Generation NCLEX Questions Dysrhythmia and Pacemaker, Chapter 35

Scenario: A 38-year-old female is admitted to the emergency department after “feeling palpitations and almost fainting.” She states that this started a few hours ago and got progressively worse as she tried to get ready for work. The ECG reveals nonconducted P waves without progressive PR intervals. On conducted beats, the PR interval is constant, with a ratio of 3:1 (three P waves to one conducted QRS interval). The ventricular rate ranges from 50 to 60. The PR interval is slightly prolonged; the QRS complex is greater than 0.12 seconds. Blood pressure is 108/54 mm hg, temperature 97.8°F (36.6°C), respirations 18 breaths/minute. Currently she is not feeling faint but reports feeling occasional palpitations. She reports that she has felt extremely tired for the past few days. The patient states that she has a family history of heart disease and that her mother had a heart attack at age 35. She denies having any chest pain or tightness. The patient states that she has smoked 1 pack of cigarettes a day for years but stopped smoking a month ago. Her skin is warm and dry, and capillary refill is brisk. 1. NGN Item Type: Highlighting/Enhanced Hot Spot Highlight or place a check mark next to the assessment findings that require follow-up by the nurse. 2. NGN Item Type: Cloze Choose the most likely options for the information missing from the statement, below, by selecting from the list of options provided. The nurse recognizes that, based on the assessment data and patient’s history, the patient is currently at risk for complications, including __________, _________, and __________. Hypotension, Options Heart failure Complete heart block Tachycardia Myocardial ischemia Decreased cardiac output First-degree heart block Hypotension Infectio