Progressive Care Nursing Certification (PCCN) Practice Exam

Which condition is a patient with a prolonged QT interval most at risk for developing?

1. Depressed ST segment

2. Development of peaked T waves

3. Torsades de pointes

4. Development of a U wave

The correct answer is: Torsades de pointes

A patient with a prolonged QT interval is at increased risk for developing Torsades de pointes, which is a specific type of polymorphic ventricular tachycardia that can lead to sudden cardiac arrest. The prolonged QT interval indicates that the heart's electrical system is taking longer than normal to repolarize after each heartbeat. This prolonged repolarization creates a substrate for abnormal electrical activity, which can manifest as Torsades de pointes in susceptible individuals. Torsades de pointes is characterized by a unique pattern on the electrocardiogram, where the QRS complexes appear to twist around the baseline, and this condition can lead to hemodynamic instability and potentially life-threatening arrhythmias. The triggers for Torsades can include electrolyte imbalances, certain medications, or inherited long QT syndromes, among other factors. Understanding the relationship between prolonged QT intervals and the risk of Torsades de pointes is essential in the context of progressive care nursing, as it emphasizes the importance of careful monitoring and management of patients with this condition to prevent serious complications.