Dysrhythmias NCLEX questions MINE

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EKG NC

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car You are the nurse working on the telemetry unit and you have finally gotten to sit down to work on some charting. Suddenly the heart monitors at the station start beeping. The patient in room 18 is showing a ventricular fibrillation rhythm on the monitor. The medical team advances together into the room and finds them unconscious. What is priority action by the nurse?

• Prepare to administer adenosine to the patient
• Begin chest compressions
• Prepare for defibrillation
• Check for a pulse
• Check for a pulse

A pulse would be assessed first. Then the patient will be defibrillated and chest compressions will begin immediately.The nurse sees a sinus tachycardia rhythm on the monitor. Which of the following lab values does the nurse identify as being most likely to have caused this dysrhythmia?

a) K 3.0

b) Ca 10.5

c) Hgb 9

d) Magnesium 2.1

c) Hgb 9

Anemia can contribute to sinus tachycardia.

The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses consciousness. The patient is defibrillated, and the rate returns as ventricular fibrillation. What should the nurse do first?

• Begin compressions
• Shock the client again immediately
• Prepare for intubation
• Administer adenosine
• Begin compressions

Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The client may need to be shocked again, but chest compressions must begin first.A patient with cardiomyopathy has been given an ICD. Which of the following medications would the nurse expect to see in the MAR for this patient?

• Warfarin
• Cardizem
• Nitroglycerin
• Digoxin
• Cardizem

Antiarrhythmic medications are prescribed with the use of an ICD in order to prevent the tachycardia (or other deadly arrhythmias) from occurring in the first place. This makes sure that the ICD is used only when absolutely necessary.The patient with a history of hypertension and diabetes has a rhythm strip indicating atrial flutter. The patient's vitals are as follows: BP 145/89, HR 90, SpO2 95%, RR 19. Which of the following does the nurse expect to do at this time?

a) Prepare the client for cardioversion STAT

b) Begin administering anticoagulants

c) Grab the crash cart for administration of adenosine

d) Teach the client about possibility of pacemaker installation

b) Begin administering anticoagulants

Atrial flutter places the client at high risk for development of clot formation in the atria. Because the client is stable at this time, cardioversion or adenosine would not be performed at this time. Before cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48 hours beforehand if possible.

The nurse is preparing to administer adenosine to the patient with the following rhythm which is symptomatic. What should the nurse plan on having in the patient room?

a) Physician

b) Crash cart

c) IV pump

d) EKG monitor

e) Lidocaine

a) Physician

b) Crash cart

d) EKG monitor

Adenosine is administered as a very quick IV push. The physician must be present in the room and the crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the medication.The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor. What is the nurse's priority intervention?

a) Apply conductive gel and defibrillate the patient

b) Document the findings and continue to monitor

c) Administer another mg of the medication

d) Begin chest compressions

b) Document the findings and continue to monitor

This finding would be expected upon administration of adenosine. The rhythm should then begin again in some other rhythm, hopefully, normal sinus rhythm. It would be important to document the exact time of this change and continue to monitor the change back to NSR. If this change does not occur, or if another rhythm is produced, appropriate action would then be taken based on the result.You, the nurse, note a SVT rhythm on the EKG monitor for a patient named billy. What is the first thing the nurse should do?

a) Check for a pulse

b) Tell Billy to try to poop

c) Prepare to defibrillate billy

d) Prepare to administer Amiodorone

b) Tell Billy to try to poop

With SVT (Supraventricular tachycardia), the first thing to do would be to instruct the pt. to perform the Valsalva maneuver by bearing down.

A group of nursing students are discussing atrial flutter. The students recognize that which of the following are seen with atrial flutter? Select all

that apply:

1) Ventricular rate of 220-300 bpm.2) Regular rhythm 3) Saw-tooth pattern 4) Measurable PR interval 5) Long QRS interval 2) Regular rhythm 3) Saw-tooth pattern The ATRIAL rate is 220-300 bpm. Ventricular is about 75-150. The rhythm is regular, with the P wave appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P wave. The QRS is normal.A nursing student is aware that which of the following is the treatment for unstable atrial flutter?1) Adenosine (Adenocard) 6 mg rapid IVP.2) Cardioversion with adjacent Heparin therapy 3) Defibrillation STAT followed by CPR.4) Altemose 3 mg IVP over 1-2 seconds.2) Cardioversion with adjacent Heparin therapy Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has stuck around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval. I made up Altemose.A nurse working on a CVT unit receives report from day shift. After receiving report, which patient should the nurse see first?1) A 23-year-old professional tennis player with a HR of 47 bpm.2) A 69-year-old male with atrial fibrillation who has new onset confusion.3) A 72-year-old female with atrial flutter who reports feeling unusually tired today and yesterday.4) A 33-year-old female with sinus tachycardia who is asking for her at-home Metoprolol.2) A 69-year-old male with atrial fibrillation who has new onset confusion.Patients with a-fib are at risk for pulmonary and systemic emboli, and new onset of confusion may indicate a stroke in this patient. Patients with atrial flutter may feel more tired some days than others.A nurse on a CVT unit views the monitor and sees the patient in room 452 has just begun having occasional PVCs. Which action should the nurse take first?1) Check on the patient 2) Check last magnesium and potassium levels 3) Document the occurrence and watch for further PVCs 4) Contact the physician 1) Check on the patient Although electrolytes are likely the culprit, the nurse first needs to first assess the patient. Then, the nurse should look in the patient's chart and evaluate or request an order for electrolyte levels. This may eventually need to be documented, but the nurse can be held liable for negligence if he/she does not assess the patient first. The physician may or may not need to be contacted.