The nurse assesses a client's ECG tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation? A. The client has hyperkalemia causing irregular QRS complexes. B. Ventricular tachycardia is overriding the normal atrial rhythm. C. The client's chest leads are not making sufficient contact with the skin. D. Ventricular and atrial depolarizations are initiated from different sites. {Ans: D. Ventricular and atrial depolarizations are initiated from different sites. Rationale: Normal rhythm shows one P wave preceding each QRS complex, indicating that all depolarizatoin is initiated at the SA node. QRS complexes without a P wave indicate a different source of initiation of depolarization. This finding on an ECG tracing is not an indication of hyperkalemia, ventricular tachycardia, or disconnection of leads.}A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition? A. Sinus tachycardia B. Speech Alterations C. Fatigue D. Dyspnea with activity {Ans: B. Speech Alterations Rationale: Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic events includes changes in mentation, speech, sensory function, and motor function. Clients with