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    Sp26 504w advanced med surg proctored exam (Massachusetts college)

    A nurse in an urgent care center is assessing a client who reports sudden-onset palpitations, fatigue, and dizziness. The nurse assesses a rapid, irregular heart rate with a significant pulse deficit and no definitive P-waves. Which dysrhythmia does the nurse expect to find on the cardiac monitor?

    Explanation & Rationale

    A. The rhythm strip shown in A exhibits a regular underlying rhythm interrupted by a Premature Ventricular Contraction (PVC), which is a wide, bizarre QRS complex occurring earlier than expected. While PVCs can cause palpitations, they do not typically present as a sustained "rapid, irregular" heart rate with a total absence of P-waves across the entire strip. B. The rhythm strip in B represents Atrial Fibrillation (AFib), characterized by a "normally irregular" ventricular response and the replacement of distinct P-waves with chaotic fibrillatory waves. In AFib, the atria quiver rather than contract, leading to a significant pulse deficit because not every electrical impulse results in a ventricular contraction strong enough to produce a peripheral pulse.

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