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    Ngu Hesi Rn Compass Exit Proctored Exam

    Based on this strip, which is the interpretation of this rhythm?

    Explanation & Rationale

    Rationales: A. Third-degree heart block presents with complete dissociation between P waves and QRS complexes, where atrial and ventricular rhythms are independent and regular, this strip shows occasional premature wide QRS complexes interrupting a sinus rhythm, not dissociation. B. Idioventricular rhythm is characterized by a slow ventricular rate (20–40 bpm) with wide QRS complexes and absent P waves throughout. In this strip, sinus P waves precede most QRS complexes, which rules out a pure ventricular origin. C. Junctional rhythm shows absent or inverted P waves and narrow QRS complexes because impulses originate near the AV node. The wide, early QRS complexes here indicate a ventricular ectopic focus, not a junctional source. D. Sinus bradycardia with PVCs is evident from a slow underlying sinus rhythm with normal P-QRS-T sequences, interrupted by premature, wide, and bizarre QRS complexes without preceding P waves, typical of PVCs.

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