NCLEX® Question of the Day: ECG Strip

Today’s NCLEX-RN® question of the day focuses on a nurse making a decision based on a client’s ECG strip characteristics.

A client’s ECG strip has the following characteristics:

• Regular rhythm
• P wave precedes each normal QRS complex
• PR interval = 0.20
• Rate = 50 beats/minute

The client is dyspneic and complains of chest pain. Based on these findings, what is the first intervention the nurse should anticipate?

A. Vagal maneuvers

B. Administer epinephrine

C. Administer atropine

D. External pacing

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The correct answer to today’s NCLEX-RN® Question is…

C.Administer atropine

Rationale:Atropine is anticholinergic and the medication of choice for treating symptomatic bradycardia. External pacing may be implemented if the atropine is not effective. Epinephrine may be implemented if atropine and external pacing is not effective.

Main takeaway

Atropine is anticholinergic and the medication of choice for treating symptomatic bradycardia.

Incorrect answer explanations

A. Vagal maneuvers

Rationale: Vagal maneuvers (Valsalva, coughing, carotid massage) are strategies used for arrhythmias such as supraventricular tachycardia, but this would decrease the heart rate and increase the severity of the client’s symptoms.

B. Administer epinephrine

Rationale: Epinephrine may be implemented if atropine and external pacing are not effective.

D. External pacing

Rationale: External pacing may be implemented if the atropine is not effective.

References

Lewis, S. L., Dirksen, S. R., Heitkemper, M. M. & Bucher, L. (2017). Medical-surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Elsevier Mosby.

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