143 Module 3 - ECG Dysrhythmias PRACTICE QUESTIONS

143 Module 3 - ECG & Dysrhythmias (PRACTICE QUESTIONS) ScienceMedicineCardiology skargoTop creator on Quizlet Save 143 Module 3 - Coronary Artery Dis...84 terms skargoPreview Dysrhythmias (EKG Strips) 16 terms haley_curry5Preview 143 Module 3 - PVD & HTN (PRACTI...154 terms skargoPreview 143 Mo 71 terms ska The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply?

• The QRS complex will be smaller in sinus bradycardia.
• The only difference is the heart rate.
• The P-R interval will be prolonged in sinus bradycardia.
• The P waves will be shaped differently.
• All characteristics of sinus bradycardia are the same as those of normal sinus rhythm except for the rate, which will be below 60 in sinus

bradycardia. The P waves will be shaped differently in other dysrhythmias. The QRS is the same voltage for sinus rhythms. The P-R interval is prolonged in atrioventricular blocks.The nurse is caring for a client who has premature ventricular contractions. After assessing the client, the nurse will likely need to document which observed sign or symptom?

• fever
• palpitations
• hypotension
• nausea
• Premature ventricular contractions usually cause a flip-flop sensation in the chest, sometimes described as fluttering, skipped beat, or

palpitations. Associated signs and symptoms include pallor, nervousness, sweating, and faintness. Symptoms of premature ventricular contractions are not nausea, hypotension, and fever.

The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?

• The sinoatrial (SA) node initiates the impulse.
• Heart rate between 60 and 150 beats/minute.
• The ventricles depolarize in 0.5 second or less.
• Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second.
• The characteristics of normal sinus rhythm are heart rate between 60 and 100 beats/minute, the SA node initiates the impulse, the impulse

travels to the AV node in 0.12 to 0.2 second, the ventricles depolarize in 0.12 seconds or less, and each impulse occurs regularly.The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia?

A. P-to-QR ratio of 1:2.

• Heart rate of 42 beats per minute (bpm).
• QR interval of 0.25 seconds.
• PR interval of 0.24 seconds.
• The heart rate of 42 bpm is slow but normal when it occurs in athletes with a sinus bradycardia. The PR interval is prolonged at 0.24 seconds,

indicating a heart block. The QR interval is prolonged and indicates ventricular delay. The ratio of P to QR should be 1:1 in sinus bradycardia.A nurse is teaching the client about the causes of fast heart rates. What client statement indicates the client requires more teaching?

• I will cut back on my smoking and drinking alcohol.
• If I take my metoprolol daily, I will be able to control my heart rate.
• I will drink coffee with only two of my meals.
• I will take my levothyroxine daily.
• Stimulation of the sympathetic nervous system with caffeinated beverages, smoking, and drinking alcohol increases heart rate. The client is

still drinking caffeine with two meals, increasing the risk for a fast heart rate. Taking medications such as metoprolol and levothyroxine will help the client maintain a normal heart rate by decreasing stimulation of the sympathetic nervous system.Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?

• Administer every five minutes during cardiac resuscitation
• Document heart rate before and after administration
• Keep the client flat for one hour after administration
• Monitor vital signs and cardiac rhythm
• The nurse should monitor the client's vital signs and cardiac rhythm for effectiveness of the medication and for side effects and should always

have emergency life support equipment available when caring for an acutely ill client. The side effects of vasopressor drugs are hypertension, dysrhythmias, pallor, and oliguria. It is not necessary to place a client flat during or after vasopressor administration. When administering cholinergic antagonists, documentation of the heart rate is necessary.A client tells the nurse my heart is skipping beats again; I'm having palpitations. After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to

• avoid caffeinated beverages.
• apply supplemental oxygen.
• lie down and elevate the feet.
• request sublingual nitroglycerin.
• If premature atrial complexes (PACs) are infrequent, no medical interventions are necessary. Causes of PACs include caffeine, alcohol,

nicotine, stretched atrial myocardium (e.g., as in hypervolemia), anxiety, hypokalemia (low potassium level), hypermetabolic states (e.g., with pregnancy), or atrial ischemia, injury, or infarction. The nurse should instruct the client to avoid caffeinated beverages.

A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next?

• Begin cardiopulmonary resuscitation
• Provide electrical cardioversion
• Administer intravenous epinephrine
• Prepare for endotracheal intubation
• In the acute care setting, when ventricular fibrillation is noted, the nurse should call for assistance and defibrillate the client as soon as

possible. If defibrillation is not readily available, CPR is begun until the client can be defibrillated, followed by advanced cardiovascular life support (ACLS) intervention, which includes endotracheal intubation and administration of epinephrine. Electrical cardioversion is not indicated for a client in ventricular fibrillation.A client is admitted to the emergency department reporting chest pain and shortness of breath. The nurse notes an irregular rhythm on the bedside electrocardiograph monitor. The nurse counts 9 RR intervals on the client's 6-second rhythm tracing. The nurse correctly identifies the client's heart rate as

• 100 bpm.
• 70 bpm.
• 80 bpm.
• 90 bpm.
• An alternative but less accurate method for estimating heart rate, which is usually used when the rhythm is irregular, is to count the number of

RR intervals in 6 seconds and multiply that number by 10. The RR intervals are counted, rather than QRS complexes, because a computed heart rate based on the latter might be inaccurately high. The same methods may be used for determining atrial rate, using the PP interval instead of the RR interval. In this instance, 9 × 10 = 90.The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?

• A client with poor kidney perfusion
• A client with third-degree heart block
• A new myocardial infarction client
• A client with atrial arrhythmias
• The nurse is correct to identify a client with atrial arrhythmias as a candidate for cardioversion. The goal of cardioversion is to restore the

normal pacemaker of the heart, as well as, normal conduction. A client with a myocardial infarction has tissue damage. The client with poor perfusion has circulation problems. The client with heart block has an impairment in the conduction system and may require a pacemaker.Two nursing students are reading EKG strips. One of the students asks the instructor what the P-R interval represents. The correct response should be which of the following?

• It shows the time it takes the AV node impulse to depolarize the ventricles and travel through the SA node.
• It shows the time it takes the AV node impulse to depolarize the atria and travel through the SA node.
• It shows the time it takes the AV node impulse to depolarize the septum and travel through the Purkinje fibers.
• It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node.
• The PR interval is measured from the beginning of the P wave to the beginning of the QRS complex and represents the time needed for sinus

node stimulation, atrial depolarization, and conduction through the AV node before ventricular depolarization. In a normal heart the impulses do not travel backward. The PR interval does not include the time it take to travel through the Purkinje fibers.

The nurse is caring for a client who has a suspected dysrhythmia. What most appropriate intervention should the nurse use to help detect dysrhythmias?

• Monitor blood pressure continuously.
• Monitor cardiac rhythm continuously.
• Palpate the client's pulse and observe the client's response.
• Provide supplemental oxygen.
• The nurse should monitor cardiac rhythm continuously. Cardiac monitors display real-time heart rate and rhythm and alert the nurse to

potentially life-threatening dysrhythmias. Monitoring blood pressure continuously and palpating the client's pulse do not help detect life- threatening dysrhythmias. Providing supplemental oxygen helps maintain adequate cardiac output and does not help detect life-threatening dysrhythmias.Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?

• Antihypertensive
• Anticoagulant
• Diuretic
• Potassium supplement
• Clients with persistent atrial fibrillation are prescribed anticoagulation therapy to reduce the risk of emboli formation associated with

ineffective circulation. The other options may be prescribed but not expected in most situations.The staff educator is teaching a class in arrhythmias. What statement is correct for defibrillation?

• The client is sedated before the procedure.
• It uses less electrical energy than cardioversion.
• It is a scheduled procedure 1 to 10 days in advance.
• It is used to eliminate ventricular arrhythmias.
• The only treatment for a life-threatening ventricular arrhythmia is immediate defibrillation, which has the exact same effect as cardioversion,

except that defibrillation is used when there is no functional ventricular contraction. It is an emergency procedure performed during resuscitation. The client is not sedated but is unresponsive. Defibrillation uses more electrical energy (200 to 360 joules) than cardioversion.To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform?

• QRS complex
• T wave
• PR interval
• P wave
• The P wave depicts atrial depolarization, or spread of the electrical impulse from the sinoatrial node through the atria. The PR interval

represents spread of the impulse through the interatrial and internodal fibers, atrioventricular node, bundle of His, and Purkinje fibers. The QRS complex represents ventricular depolarization. The T wave depicts the relative refractory period, representing ventricular repolarization.The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include?

• Do not be concerned if you experience symptoms of lightheadedness and dizziness.
• It is not necessary to learn how to take your own pulse.
• Your family and friends may want to take a CPR class.
• If you miss a dose of your antiarrhythmic medication, double up on the next dose.
• Having friends and family learn to perform CPR will help the client manage the arrhythmia. Monitoring pulse rate at home also helps the

client manage the condition. Antiarrhythmic medication should be taken on time. Lightheadedness and dizziness should be reported to the provider.