1.
When analyzing an ECG strip, the nurse ascertains which of the following measurements are outside of normal limits?
Correct Answer
B. PR Interval 0.30, QRS 0.06
Explanation
The PR Interval of 0.30 and the QRS of 0.06 are outside of normal limits. The PR Interval represents the time it takes for the electrical signal to travel from the atria to the ventricles, and a prolonged PR Interval may indicate a conduction delay. The QRS complex represents ventricular depolarization, and a widened QRS complex may suggest a conduction abnormality or bundle branch block. Therefore, the given measurements indicate abnormalities in the conduction system of the heart.
2.
Which of the following must be included when interpreting an ECG strip?
Correct Answer
B. PR interval
Explanation
The PR interval must be included when interpreting an ECG strip. The PR interval represents the time it takes for the electrical impulse to travel from the atria to the ventricles. It is an important measurement in determining the conduction system's functionality and can help identify abnormalities such as heart block. By analyzing the PR interval, healthcare professionals can gain insights into the electrical activity of the heart and make appropriate diagnoses or treatment decisions.
3.
The nurse correlates the QRS complex to the cardiac cycle by stating, “The QRS complex represents…”
Correct Answer
D. "ventricular depolarization.”
Explanation
The nurse correctly correlates the QRS complex to the cardiac cycle by stating that it represents ventricular depolarization. Depolarization refers to the change in electrical charge that occurs in the heart muscle cells, causing them to contract. The QRS complex is a waveform on an electrocardiogram (ECG) that represents the depolarization of the ventricles, which are the lower chambers of the heart responsible for pumping blood to the rest of the body. Therefore, the nurse's statement is accurate in explaining the role of the QRS complex in the cardiac cycle.
4.
When analyzing an ECG, the nurse correlates movement of the waveform horizontally across ECG paper with
Correct Answer
D. Time.
Explanation
When analyzing an ECG, the nurse correlates movement of the waveform horizontally across ECG paper with time. This means that the nurse is looking at how the waveform changes over a specific period, which helps in identifying abnormalities or patterns in the heart's electrical activity. The amplitude refers to the height of the waveform, voltage refers to the electrical potential difference, and intensity refers to the strength or power of the waveform, none of which are directly related to the horizontal movement on the ECG paper.
5.
When assessing the ECG of a client who is experiencing chest pain, the nurse observes that the ST segment is 3 millimeters below the isoelectric line. The nurse determines that this is
Correct Answer
B. Suggestive of myocardial ischemia.
Explanation
The nurse determines that the ST segment being 3 millimeters below the isoelectric line is suggestive of myocardial ischemia. In a normal ECG, the ST segment should be at the isoelectric line. However, when it is depressed or elevated, it can indicate myocardial ischemia, which is a lack of blood flow to the heart muscle. This finding should be taken seriously as it may indicate an ongoing heart problem and requires further evaluation and intervention.
6.
Which of the following statements indicates that the student nurse understands the sequence method of measuring ECGs?
Correct Answer
C. “I need to select an R wave that falls on dark vertical line and number the next 6 dark vertical lines as 300, 150, 100, 75, 60, 50.”
Explanation
The correct answer indicates that the student nurse understands the sequence method of measuring ECGs because it explains the process of selecting an R wave that falls on a dark vertical line and numbering the next 6 dark vertical lines as 300, 150, 100, 75, 60, and 50. This method is commonly used to measure heart rate on an ECG by counting the number of dark vertical lines between R waves and using the assigned numbers to calculate the heart rate.
7.
When studying an ECG strip, the nurse observes the presence of a Q wave and determines that this waveform is
Correct Answer
D. Both A and C.
Explanation
The correct answer is "Both A and C." The nurse observes the presence of a Q wave in an ECG strip. A Q wave is defined as the first downward deflection following the P wave. This means that option A is correct. Additionally, a Q wave is considered normal if it is less than 0.04 sec duration and less than 25% of the amplitude of the R wave. Therefore, option C is also correct. Both options A and C accurately describe the characteristics and significance of a Q wave in an ECG strip.
8.
Which of the following ECG findings require further evaluation? (Select all that apply)
Correct Answer(s)
B. PR interval of 0.18sec
C. QRS complex of 0.14sec
Explanation
The PR interval measures the time it takes for the electrical signal to travel from the atria to the ventricles. A PR interval of 0.18sec is longer than the normal range (0.12-0.20sec), indicating a possible conduction delay. This finding requires further evaluation as it could be a sign of atrioventricular (AV) block or other cardiac conduction abnormalities. On the other hand, a QRS complex of 0.14sec falls within the normal range (0.06-0.10sec) and does not require further evaluation. A QRS complex of 0.06sec is abnormally narrow, indicating a possible conduction abnormality, and also requires further evaluation.
9.
Which of the following statements indicates the nurse is analyzing an ECG strip appropriately?
Correct Answer
D. “It is important to analyze the ECG strip in a systematic fashion.”
Explanation
The correct answer is "It is important to analyze the ECG strip in a systematic fashion." This statement indicates that the nurse understands the importance of following a specific order or method when analyzing an ECG strip. This systematic approach ensures that all necessary measurements and evaluations are performed accurately and thoroughly, leading to a more accurate interpretation of the ECG.
10.
Which of the following conditions put a client at risk for developing dysrhythimas?
(Please select all that apply)
Correct Answer(s)
A. Chronic Obstructive Pulmonary Disease (COPD)
C. Sick Sinus Syndrome
Explanation
Both Chronic Obstructive Pulmonary Disease (COPD) and Sick Sinus Syndrome can put a client at risk for developing dysrhythmias. COPD can lead to hypoxia and acidosis, which can disrupt the electrical conduction system of the heart. Sick Sinus Syndrome is a condition where the sinus node, the natural pacemaker of the heart, does not function properly, leading to irregular heart rhythms. An SaO2 of 95% and a serum potassium level of 4.1 mEq/L are within normal ranges and do not directly put a client at risk for developing dysrhythmias.