A nurse is reviewing a client's cardiac monitor for dysrhythmias. Which of the following findings should the nurse identify as an indication for the placement of a permanent pacemaker?

A. Vasovagal bradycardia without symptoms is usually benign and does not typically require a permanent pacemaker. Management is often conservative unless syncope or hemodynamic instability occurs. B. Sinus tachycardia is a physiologic or compensatory response to stress, fever, or dehydration. A permanent pacemaker is not indicated for tachycardia; treatment targets the underlying cause. C. A complete (third-degree) atrioventricular block results in a failure of atrial impulses to reach the ventricles. If the ventricular rate is extremely slow (<40/min), the client is at risk for syncope, heart failure, and sudden cardiac death. Permanent pacemaker placement is indicated to maintain adequate cardiac output and prevent complications. D. Second-degree AV block can be monitored if the client is asymptomatic. Pacemaker placement is reserved for symptomatic cases (e.g., dizziness, syncope) or higher-degree block progression.