Arrhythmia NCLEX-style questions

Arrhythmia NCLEX-style questions ScienceMedicineNursing Alix_VanderWiele Save Which of the following postimplantation instructions must a nurse provide a patient with a permanent pacemaker?

• Delay activities such as swimming and bowling for at least 3 weeks
• Avoid sources of electrical interference
• Keep moving the arm on the side where the pacemaker is inserted
• Keep the arm on the side of the pacemaker higher than the head

B The nurse must instruct the patient with a permanent pacemaker to avoid sources of electrical interference. Also, instruct the patient to avoid strenuous movement, keep the arm on the side of the pacemaker lower then the head except for brief moments when dressing or performing hygiene, and to delay for at least 8 weeks activities such as swimming, bowling, tennis, mowing, etc.

Which of the following nursing interventions must a nurse perform when administering prescribed vasopressors to a patient with a cardiac dysrhythmia?

• Monitor vitals and cardiac rhythm
• Administer every 5 minutes during cardiac resuscitation
• Keep the patient flat for one hour after administration
• Document heart rate before and after administration

A The nurse should monitor the patient's vitals 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 patient.The side effects of vasopressor drugs are hypertension, dysrhythmias, pallor, oliguria.Which of the following dysrhythmias are common in older patients?

• Atrial fibrillation
• Sinus tachycardia
• Ventricular tachycardia
• Sinus bradycardia

D Which of the following nursing interventions is required to prepare a patient with cardiac dysrhythmia for an elective electrical cardioversion?

• Monitor blood pressure every 4 hours
• Facilitate CPR until the patient is prepared for cardioversion
• Instruct the patient to restrict food and oral intake
• Administer digitalis and diuretics 24 hours before cardioversion

C

The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?

• Recognize that the view of the electrical current changes in relation to the lead placement
• Recognize that the electrophysiological conduction of the heart differs with lead

placement

• Inform the technician that the ECG equipment has malfunctioned
• Inform the physician that the patient is experiencing a new onset of dysrhythmia.

A Differences between leads are not necessarily attributable to equipment malfunction or dysrhythmia The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patients heart?

• P wave
• T wave
• U wave
• QRS complex

B The T wave specifically represents ventricular muscle depolarization, also referred to as the resting state. Ventricular muscle depolarization does not result in the P wave, U wave, or QRS complex.The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?

• P wave
• T wave
• QRS complex
• U wave

C The QRS complex represents the depolarization of the ventricles and, as such, the electrical activity of that ventricle.

An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?

• PP interval and RR interval are irregular.
• PP interval is equal to RR interval.
• Fewer QRS complexes than P waves
• PR interval is constant.

C In third-degree AV block, no atrial impulse is conducted through the AV node into the ventricles. As a result, there are impulses stimulating the atria and impulses stimulating the ventricles. Therefore, there are more P waves than QRS complexes due to the difference in the natural pacemaker (nodes) rates of the heart The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?

• Maintain a resting heart rate below 70 bpm
• Maintain adequate control of chest pain
• Maintain adequate cardiac output.
• Maintain normal cardiac structure.

C For patient safety, the most appropriate goal is to maintain cardiac output to prevent worsening complications as a result of decreased cardiac output A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?

• Chest pain
• Bleeding at the implantation site
• Malignant hyperthermia
• Bradycardia

B Bleeding, hematomas, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantations.