VSSC Nursing Officer - 2021
Medical & Surgical Nursing
Easy
In ECG recognizable QRS complex is absent in
Appeared in: VSSC Nursing Officer - 2021
Explanation
- Ventricular fibrillation (VF) is characterized by chaotic, rapid, and uncoordinated electrical activity in the ventricles.
- This disorganized activity prevents the ventricles from contracting effectively, leading to a complete loss of cardiac output.
- On an ECG, this translates to an irregular, fibrillatory baseline with no discernible P waves, QRS complexes, or T waves.
- The absence of the QRS complex is the defining feature, indicating no organized ventricular depolarization is occurring.
- As seen in the image, the waveform is completely chaotic, confirming the diagnosis of VF.
Why Other Options Were Wrong
- Option B: In Atrial Fibrillation, the QRS complexes are present. The atria fibrillate, leading to the absence of P waves and an irregularly irregular rhythm, but the ventricles still depolarize, creating QRS complexes.
- Option C: Sinus arrhythmia has normal P waves, QRS complexes, and T waves. The only abnormality is a slight, cyclical variation in the R-R interval that corresponds with the respiratory cycle.
- Option D: In Paroxysmal Ventricular Tachycardia (PVT), QRS complexes are present. They are typically wide (greater than 0.12s) and have a bizarre morphology because the impulse originates in the ventricles and spreads abnormally.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain ECG interpretation and identification of life-threatening cardiac arrhythmias as background academic context rather than a clinical decision trigger.
- Recognizing Ventricular Fibrillation is a critical nursing skill. It is a pulseless, lethal arrhythmia that requires immediate intervention to prevent death.
- The primary treatment for VF is immediate high-quality CPR and defibrillation. Any delay in treatment significantly reduces the chance of survival.
- Nurses must be proficient in using a defibrillator and following Advanced Cardiac Life Support (ACLS) protocols for managing cardiac arrest.
How to Approach the Question
- First, analyze the question stem to identify the key feature being asked about: the absence of a recognizable QRS complex.
- Next, examine the provided ECG image. Observe its characteristics: is it regular or irregular? Are there P waves? Are the QRS complexes present, and if so, are they narrow or wide? The image shows a chaotic baseline with no clear waves.
- Evaluate each option based on its known ECG characteristics.
- Option A (Ventricular fibrillation): Recall that VF is a chaotic rhythm where organized ventricular depolarization ceases, resulting in no QRS complexes. This matches the image and the question.
- Option B (Atrial fibrillation): Recall that AF has QRS complexes but lacks P waves and has an irregularly irregular rhythm.
- Option C (Sinus arrhythmia): Recall that this is a normal sinus rhythm with all components present, just with rate variation.
Concept Tested & Keywords
- Concept Tested: ECG interpretation and identification of life-threatening cardiac arrhythmias.
- Stem keywords: ECG, QRS complex, absent
- Lead-in keywords: absent
- Clinical cues: The image shows a chaotic, disorganized ECG waveform, which is a key visual cue for Ventricular Fibrillation.
Question ID
Q0SvDt02QDaXYUFUnuQ2V9
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 234-236
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 7321-7323
E6 Pharmacology Katzung 16e p. 364-366
Practise the full VSSC Nursing Officer - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Cardiovascular, Circulatory, and Hematologic Function Questions
- A patient was brought to ED with complaint of chest pain from last 1 hour. Which test is done to detect myocardial infarction?
- A patient is undergoing blood transfusion and suddenly shows complaints of transfusion reaction. What will be the priority nursing intervention?
- Normal hemoglobin level in adult is:
- The following all are blood transfusion complications from; EXCEPT:
- Symptoms of acute blood loss are:
- An obstruction of blood flowing from the left atrium into the left ventricle is known as:
- 'Sequestration crisis' is related to:
- Which is the most common HIV related malignancy?
- Calculate the pulse pressure from the below image of cardiac monitor:
- Identify the use of following machine used in pneumatic compression device:
More VSSC Nursing Officer - 2021 Questions
- World no tobacco day is observed on
- The position recommended for a patient with epistaxis?
- Nerve supplying to diaphragm
- Heimlich maneuver is used for?
- A patient with ascites should take a diet which is?
- Bluish discolouration of cervix during pregnancy?
- Salt losing syndrome is a feature of
- False ideas or beliefs that the patient accepts as real are called?
- Flashbacks of an unpleasant terrifying or painful experience may occur in?
- Burning and tingling sensations of feet in an alcoholic is suggestive of?