when printing out an ekg a nurse notices that the qrs complexes are extremely small what should be the next step

NCLEX-RN

NCLEX RN Predictor Exam

1. When printing out an EKG, a nurse notices that the QRS complexes are extremely small. What should be the next step?

A. Alert the physician immediately as this is a sign of impending cardiac arrest.
B. Check to see that all leads are attached and rerun the EKG.
C. Increase the sensitivity control to 20 mm deflection.
D. Decrease the run speed to 50.

Correct answer: C

Rationale: Increasing the sensitivity control to 20 mm deflection will double the sensitivity, allowing for better observation of the small QRS complexes. This step is crucial in obtaining a clearer EKG reading. Choice A is incorrect because small QRS complexes do not necessarily indicate impending cardiac arrest; it's more likely a technical issue. Choice B is not the first step to take when small QRS complexes are observed; it's important to adjust the settings first. Choice D is incorrect because decreasing the run speed to 50 is not the appropriate action for this situation; adjusting the sensitivity control is more relevant to improve the visualization of the complexes.

2. Which of the following is NOT an acceptable abbreviation?

A. D/C
B. tid
C. bid
D. qid

Correct answer: A

Rationale: The correct answer is A: D/C. D/C is not an acceptable abbreviation as it can be easily confused with both 'discharge' and 'discontinue.' The abbreviations 'tid' (three times a day), 'bid' (twice a day), and 'qid' (four times a day) are commonly used in medical contexts to indicate dosing frequencies and are widely accepted in healthcare settings.

3. Which of the following actions can help prevent a fire in the area where a healthcare professional works?

A. Using an adaptor when plugging in client equipment
B. Marking equipment that is not working properly and using it carefully until it can be inspected by maintenance
C. Notifying visitors or posting signs that indicate oxygen is in use in certain areas
D. Keeping extra equipment stored in one area with other supplies and materials

Correct answer: C

Rationale: The correct action to help prevent a fire in a healthcare setting is to notify visitors or post signs indicating that oxygen is in use in certain areas. Oxygen is a combustible material, and awareness of its presence is crucial to prevent fire hazards. By informing all individuals in the facility about the use of oxygen through clear signs or notifications, the risk of improper use and potential fire accidents can be minimized. Choice A is incorrect because using an adaptor when plugging in client equipment is not directly related to fire prevention. Choice B is also incorrect as marking faulty equipment and using it until inspection does not directly address fire prevention. Choice D is not a recommended action for fire prevention; storing extra equipment with supplies does not address the specific fire risk associated with oxygen use.

4. Which of the following vital signs can be expected in a child that is afebrile?

A. Rectal Temp of 100.9 degrees F.
B. Oral Temp of 38 degrees C.
C. Axillary Temp of 98.6 degrees F.
D. All of the above are incorrect.

Correct answer: C

Rationale: The correct answer is the axillary temperature of 98.6 degrees F. Afebrile means without a fever, and an axillary temperature, which is taken in the armpit, is considered normal at 98.6 degrees F. Choice A is incorrect as a rectal temperature of 100.9 degrees F indicates a fever. Choice B is incorrect as an oral temperature of 38 degrees C is also indicative of a fever. Choice D is incorrect as not all options are wrong; only choices A and B are incorrect for an afebrile child.

5. To properly read a meniscus,

A. hold the measuring device at eye level and read the bottom of the curve of the liquid level
B. hold the measuring device at eye level and read the top of the curve of the liquid level where the liquid adheres to the walls of the container.
C. hold the measuring device at table level and, looking down into the measuring device, read the bottom of the curve of the liquid level.
D. hold the measuring device at table level and, looking down into the measuring device, read the top of the curve of the liquid level.

Correct answer: A

Rationale: To properly read a meniscus, it is essential to hold the measuring device at eye level to avoid parallax error. Reading the bottom of the curve of the liquid level is correct because the meniscus is the concave or convex curve at the liquid's surface. Choice B is incorrect because reading the top of the curve where the liquid adheres to the walls of the container can lead to inaccurate measurements. Choices C and D are incorrect as they suggest holding the device at table level, which can introduce parallax error and result in an incorrect reading.