{"id":8959,"date":"2025-12-17T00:01:57","date_gmt":"2025-12-17T08:01:57","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=8959"},"modified":"2026-04-14T14:09:57","modified_gmt":"2026-04-14T22:09:57","slug":"nclex-question-of-the-day-second-degree-heart-block","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-second-degree-heart-block","title":{"rendered":"NCLEX-RN\u00ae Question of the Day: Second-Degree Heart Block"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-second-degree-heart-block\/#The_correct_answer_to_todays_NCLEX%C2%AE_Question_is%E2%80%A6\" >The correct answer to today&#8217;s NCLEX\u00ae Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-second-degree-heart-block\/#Main_Takeaway\" >Main Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-second-degree-heart-block\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-second-degree-heart-block\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Today&#8217;s NCLEX-RN\u00ae question of the day focuses on a second-degree heart block and a new medication. Do you know the answer? Let&#8217;s find out!<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <strong>nurse in the emergency department<\/strong> is gathering a <strong>health history<\/strong> for a <strong>patient who presents with intermittent chest pain occurring for several days<\/strong> and has a <strong>history of kidney disease.<\/strong> An <strong>electrocardiogram (ECG)<\/strong> is performed, which shows a <strong>second-degree heart block.<\/strong> The nurse learns the <strong>patient was recently started on several medications.<\/strong> Which <strong>medication could potentially cause this condition?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Lisinopril<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Prednisone<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Diltiazem<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Albuterol&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Nurses Learn by Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kGJCkPfFypA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_NCLEX%C2%AE_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s NCLEX\u00ae Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Diltiazem<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> <strong>Diltiazem<\/strong> is a <strong>calcium channel blocker<\/strong> that can <strong>slow conduction through the heart.<\/strong> One of the <strong>side effects of diltiazem<\/strong> is <strong>heart block<\/strong>, especially for <strong>patients who are at risk of developing diltiazem toxicity due to renal damage.<\/strong> Therefore, this medication is <strong>most likely the cause of the patient\u2019s new onset atrioventricular block.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Takeaway\"><\/span>Main Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Heart blocks<\/strong>, or <strong>atrioventricular (AV) blocks<\/strong>, are typically caused by any kind of <strong>structural damage or fibrosis to the electrical conduction system.<\/strong> <strong>Toxicity with calcium channel blockers, such as diltiazem, and other medications such as digoxin and beta blockers<\/strong> can cause <strong>delayed conduction resulting in a heart block<\/strong>, especially for <strong>patients with impaired drug excretion due to kidney damage.<\/strong> <strong>Heart damage of any kind<\/strong> is also strongly associated with <strong>risk for heart block.<\/strong> This includes <strong>ischemic heart disease, previous or recent myocardial infarction, congenital heart disease, myocarditis,<\/strong> as well as <strong>rheumatic fever.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Lisinopril<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> Lisinopril is an <strong>angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure<\/strong>. This medication is not typically associated with the risk of developing a heart block.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Prednisone<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> Prednisone is a <strong>corticosteroid used to decrease inflammation<\/strong> in the body. This medication is not typically associated with the risk of developing a heart block.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Albuterol<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> Albuterol is a <strong>beta-adrenergic agonist<\/strong> <strong>that helps dilate the bronchioles<\/strong> when inhaled and is used to treat asthma. This medication typically causes an increase in heart rate and does not typically cause a heart block.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Watch the Osmosis video: <a href=\"https:\/\/www.osmosis.org\/learn\/Calcium-channel_blockers:_Nursing_pharmacology\">Calcium-channel blockers: Nursing pharmacology<\/a><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/01\/Blog_Display_Ads_RN1_2023_535910.png?w=700\" alt=\"\" class=\"wp-image-5083\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/01\/Blog_Display_Ads_RN1_2023_535910.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/01\/Blog_Display_Ads_RN1_2023_535910.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Try Osmosis today! Access your&nbsp;<a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\">f<\/a><a href=\"https:\/\/www.osmosis.org\/create\" target=\"_blank\" rel=\"noreferrer noopener\">ree trial<\/a>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Learn how certain medications can lead to second-degree heart block, particularly in patients with kidney impairment.<\/p>\n","protected":false},"author":279,"featured_media":8962,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[20,29,1367,1366,32],"tags":[580,2369,1477,2373,2370,2371,431,2376,2375,2374,2372,244,245,815,2368],"class_list":["post-8959","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-exam-prep","category-nclex","category-nclex-rn","category-questions","category-nursing","tag-av-block","tag-calcium-channel-blockers","tag-cardiac-arrhythmias","tag-cardiac-conduction","tag-diltiazem","tag-drug-toxicity","tag-ecg-interpretation","tag-heart-block-causes","tag-kidney-disease","tag-medication-assessment","tag-medication-side-effects","tag-nclex-rn","tag-nursing-education","tag-nursing-pharmacology","tag-second-degree-heart-block"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - 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