# A client with a temporary ventricular pacemaker becomes dizzy. The nurse checks the client and the monitor. Click the interval showing electrical output without the expected ventricular response, supporting a capture problem.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=581195&lang=en  
> language: en  
> subject: Physiological Adaptation  
> category: PA

## Question

A client with a temporary ventricular pacemaker becomes dizzy. The nurse checks the client and the monitor. Click the interval showing electrical output without the expected ventricular response, supporting a capture problem.

![](https://mymerci.kr/data/nclex/hotspot/regen_20260908_2350/HSR532.svg)

## Explanation

C contains pacing spikes that are not followed by ventricular QRS complexes.

## In-depth explanation

Quick answer
C. C contains pacing spikes that are not followed by ventricular QRS complexes.
Why this is the best choice
A visible pacing spike establishes electrical output, not capture. In C, small atrial deflections persist but the expected large ventricular complexes do not follow the spikes. Assess perfusion promptly and escalate; continue to evaluate connections and the cause of failed capture.
Clinical picture
The observations are fictional teaching data. Apply the stated context; the selected feature does not by itself replace a complete bedside assessment.
Memory hook
A pacemaker spike is output; a following QRS is electrical ventricular capture.
Decision rule
A pacemaker spike is output; a following QRS is electrical ventricular capture.
Why the other regions do not fit
A, B and D show a QRS following each pacing spike. Their visible spikes are not by themselves a malfunction. C has output but lacks the expected ventricular response.
**Sources**
- Failure to capture presents as pacing spikes without the expected depolarization.

## Key concepts

- **Pacing output versus ventricular capture** — A pacemaker spike is output; a following QRS is electrical ventricular capture.
- **Comparison with context** — Small deflections remain in C and may be mistaken for successful ventricular complexes.

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