The client has an EKG showing a gradually lengthening PR interval and a dropped QRS at the longest PR interval. What rhythm does the client have?

Correct Answer: A

Rationale: The correct answer is A: Third degree AV block. In this condition, there is complete dissociation between the atria and ventricles, leading to independent rhythms. The gradually lengthening PR interval followed by a dropped QRS complex is characteristic of third degree AV block. The atria and ventricles are firing independently, resulting in no association between the P waves and QRS complexes. Choices B, C, and D do not match the description provided and do not involve complete dissociation between the atria and ventricles as seen in third degree AV block.

Correct Answer: C

Rationale: The correct answer is C, “What time did your chest pain begin?” This question is crucial in determining if the patient is within the time window for thrombolytic therapy, which is typically within the first 12 hours of symptom onset. This therapy is most effective when administered early after symptom onset to dissolve the blood clot causing the myocardial infarction. Asking about the time of chest pain onset helps assess if the patient falls within this critical treatment window. Choice A, “Do you have any allergies?” is not directly relevant to the decision of thrombolytic therapy administration. Choice B, “Do you take aspirin on a daily basis?” is important for the patient’s medical history but does not directly impact the decision for thrombolytic therapy. Choice D, “Can you rate your chest pain using a 0 to 10 scale?” may provide information about the severity of pain but does not help in determining the eligibility for thrombolytic therapy based on the treatment

Correct Answer: A

Rationale: The correct answer is A because teaching the patient about when cardiac rehabilitation will begin is crucial for their recovery post-AMI and percutaneous coronary intervention. Cardiac rehabilitation plays a vital role in improving outcomes and quality of life for these patients. Option B, C, and D are incorrect as emotional responses to AMI, information regarding discharge medications, and pathophysiology of coronary artery disease are important but not the immediate priority for a patient in this situation.

Correct Answer: D

Rationale: The correct answer is D: Reinforcement of teaching about the purpose of prescribed medications. This task can be safely delegated to an experienced LPN/LVN as it involves providing information that has already been taught by the RN. The LPN/LVN can reinforce the teaching without interpreting or altering the content. This task does not require critical thinking or assessment skills beyond the scope of practice for an LPN/LVN. A, evaluation of the patient's response to walking in the hallway, involves physical assessment and monitoring for any adverse signs or symptoms, which requires the RN's expertise. B, completion of the referral form for a home health nurse follow-up, involves coordination of care and decision-making, which falls under the RN's responsibility. C, education of the patient about the pathophysiology of heart disease, involves complex medical information and understanding, which is beyond the scope of practice for an LPN/LVN.

Correct Answer: A

Rationale: The correct answer is A: PTT (Partial Thromboplastin Time). PTT measures the effectiveness of heparin therapy by assessing the clotting time. Monitoring PTT helps ensure the therapeutic range of heparin is maintained to prevent clot formation. Incorrect Choices: B: HCT (Hematocrit) - measures the percentage of red blood cells in the blood, not specific to heparin monitoring. C: CBC (Complete Blood Count) - provides overall information about blood cells, not specific to heparin monitoring. D: PT (Prothrombin Time) - used to monitor Warfarin therapy, not heparin.