The client has atrial fibrillation. What can the nurse say about the P wave?

Correct Answer: C

Rationale: The correct answer is C: The P wave is absent. In atrial fibrillation, the atria are quivering and not contracting effectively, leading to the absence of distinct P waves on the ECG. This is due to the chaotic electrical activity in the atria. Rationale: A: The P wave does not precede a long PR interval in atrial fibrillation. Instead, the irregular electrical signals cause variable PR intervals. B: The P wave falling on the previous T wave is not a characteristic of atrial fibrillation. The T wave represents ventricular repolarization, whereas the P wave reflects atrial depolarization. D: The P wave being peaked is not relevant to atrial fibrillation. In this arrhythmia, the absence of distinct P waves is a key feature due to the erratic atrial activity.

Correct Answer: D

Rationale: The correct answer is D because monitoring the patient's ability to participate in daily activities without chest pain is a direct assessment of the effectiveness of Nadolol in managing chronic stable angina and left ventricular dysfunction. If the patient can engage in activities without experiencing chest pain, it indicates that the drug is effectively controlling angina symptoms. Option A is incorrect because Nadolol may not significantly decrease blood pressure and heart rate in this context. Option B is incorrect as cold hands and feet are not specific indicators of Nadolol's effectiveness for angina. Option C is also incorrect as improvement in distal pulses may not directly correlate with the drug's efficacy in managing angina symptoms.

Correct Answer: B

Rationale: The correct answer is B because incisions in the leg are not made for harvesting the internal mammary artery in CABG surgery; instead, the internal mammary artery is typically accessed through a small incision in the chest. This shows a misunderstanding of the surgical procedure. A, C, and D are incorrect: A: Correct, as it shows understanding that a heart-lung machine will circulate blood during surgery. C: Correct, as it demonstrates knowledge of using an artery near the heart for bypass. D: Correct, as it indicates awareness of postoperative medication regimen.

Correct Answer: A

Rationale: The correct answer is A: Attach the heart monitor. This should be done first to continuously monitor the patient's heart rhythm and detect any arrhythmias or changes. Monitoring the heart is crucial in NSTEMI cases to identify any potential complications. Obtaining the blood pressure (Choice B) is important but not as urgent as monitoring the heart. Assessing peripheral pulses (Choice C) and auscultating breath sounds (Choice D) are also important assessments but do not take precedence over monitoring the heart in a NSTEMI patient.

Correct Answer: B

Rationale: The correct answer is B: Assess the client. When a cardiac monitor alarm sounds for ventricular tachycardia, the nurse's initial action should be to assess the client to determine the client's level of consciousness, pulse quality, and overall condition. This assessment helps the nurse gather crucial information to determine the appropriate next steps and interventions. Performing immediate defibrillation (A) is not the first action as the client's status needs to be assessed first. Calling the physician (C) can cause a delay in providing immediate care, and administering a precordial thump (D) is not recommended as it may not be effective and could delay appropriate interventions.