Pharm - Archer Review - Endo...

Dysrhythmias Practice Q's ScienceMedicineCardiology clarissaroseyu Save Pharm - Archer Review (3/4) - Endo...132 terms carlydenbraber9 Preview Relias Dysrhythmia Basic A 55 terms charless_fink Preview Med Surg Ch 29 Cardiac Dysrhythmi...28 terms ArcaneD2Preview Skills 3 29 terms Ext 100. In analyzing a patient's electrocardiogram (ECG) rhythm strip, the nurse uses the knowledge that the time of the conduction of an impulse through the Purkinje fibres is represented by which of the following changes?

• P wave
• PR interval
• QT interval
• QRS complex

B

• Which of the following is an abnormal ECG value for a PR interval duration?
• 0.6 second
• 0.12 second
• 0.24 second
• 0.30 second

B

• A patient has a sinus arrest with a junctional escape rhythm. What would the nurse expect the patient's pulse rate to be?
• 15 to 20 beats/min
• 20 to 40 beats/min
• 40 to 60 beats/min
• 60 to 100 beats/min

C

• A patient who is complaining of a "racing" heart and nervousness comes to the emergency department. The patient's blood pressure (BP) is

102/68 mm Hg. The nurse places the patient on a cardiac monitor and obtains the following ECG tracing: Which action should the nurse take next?

• Have the patient perform the Valsalva manoeuvre.
• Prepare to administer -blocker medication to slow the heart rate.
• Get ready to perform electrical cardioversion.
• Obtain further information about possible causes for the heart rate

D

ANS: D

The patient has sinus tachycardia, which can be caused by multiple stressors such as pain, dehydration, or myocardial ischemia. Further assessment is needed before determining the treatment

• A patient has a dysrhythmia that requires careful monitoring of atrial activity. Which lead will be best to use for continuous monitoring?
• MCL1
• AVF
• V6
• I

A

• The nurse obtains a monitor strip on a patient admitted to the coronary care unit with a myocardial infarction (MI) and makes the following

analysis: P wave not apparent; ventricular rate 142 beats/min, R-R interval regular; PR interval not measurable; and QRS complex wide and distorted, greater than 0.14 second. The nurse interprets this patient's cardiac rhythm as which of the following?

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

D

• The nurse determines that a patient has ventricular bigeminy when the rhythm strip indicates which of the following changes?
• Conduction is originating in the AV node.
• Every other QRS complex is wide and starts prematurely.
• The ventricular rate is between 150 and 250 beats/min.
• The rhythm of the SA node is coupled with long pauses between every two beats.

B

• A patient has a normal cardiac rhythm strip, except that the PR interval is 0.34 seconds. What is the appropriate nursing intervention?
• Notify the physician.
• Administer atropine per protocol.
• Prepare the patient for temporary pacemaker insertion.
• Document the finding, and continue to monitor the patient

D

• A patient with diabetes mellitus is admitted unresponsive to the emergency department (ED). Initial laboratory findings are serum potassium

2.8 mmol/L, serum sodium 138 mmol/L, serum chloride 90 mmol/L, and blood glucose 34.9 mmol/L (628 mg/dL). Cardiac monitoring shows multifocal premature ventricular contractions (PVCs). What does the nurse understand that the patient's PVCs are most likely caused by?

• Hypoxemia
• Dehydration
• Hypokalemia
• Hyperglycemia

C

• The nurse retrieves data from the cardiac monitor that indicates that a patient with an MI experienced a 45-second episode of ventricular

tachycardia before a normal sinus rhythm and a heart rate of 98 were re-established. What is the most appropriate initial nursing action?

• Notify the physician.
• Administer antidysrhythmic drugs per protocol.
• Elevate the head of the bed, and administer oxygen at 6 L/min.
• Continue to monitor the patient's cardiac rhythm without other interventions at this time

B

• A patient is seen in the emergency department after experiencing dizziness and shortness of breath for several days. During cardiac

monitoring in the ED, the nurse notes the following findings: atrial rate 82 beats/min, P-P interval regular; ventricular rate 42 beats/min, R-R interval regular; PR interval variable with no relationship between P and QRS; and QRS complex 0.06 second with normal contour. The following

ECG tracing was obtained:

The nurse interprets this cardiac rhythm as which of the following?

• Third-degree heart block
• Premature atrial contractions
• PVCs
• Paroxysmal supraventricular tachycardia

A

• A patient with myocardial damage develops a type I, second-degree AV block. The nurse administers IV atropine as prescribed. The nurse

determines that the medication has been effective on finding which of the following changes?

• A decrease in ventricular response
• A decrease in premature contractions
• An increase in the patient's heart rate
• Increased carotid and peripheral pulse volume

C

• What is the most accurate way to calculate the heart rate from an ECG?
• Count the number of R-R intervals in 6 seconds, and multiply by 10.
• Count the number of small squares between the R-R interval, and divide by 1500.
• Count the number of QRS complexes in 1 minute.
• Count the large squares between one R-R interval, and divide by 300.

C

• The cardiac monitor alarm goes off for a patient being monitored in the coronary care unit, and the nurse notes a cardiac pattern of

undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious, with no pulse or respirations. After calling for assistance, what should the nurse do?

• Start basic cardiopulmonary resuscitation (CPR).
• Administer a bolus dose of epinephrine.
• Prepare the patient for endotracheal intubation.
• Wait for the defibrillator to arrive at the bedside.

A

• During the change-of-shift report, the nurse learns that a patient with a large MI has been having frequent PVCs. What will the nurse check

when monitoring the patient for the effects of PVCs?

• The patient's medications
• The patient's oxygen saturation
• The patient's apical-radial heart rate
• The patient's recent electrolyte values

C

• How would the nurse document a dysrhythmia pattern that has a sawtooth-shape P wave, a variable PR interval, and a normal QRS

complex?

• Junctional rhythms
• Atrial flutter
• Sinus bradycardia
• Atrial fibrillation

B

• Which classification of antidysrhythmia drugs has no effect on ECG?

a. Class I: sodium channel blockers

b. Class II: -adrenergic blockers

c. Class III: potassium channel blockers

d. Class IV: calcium channel blockers

A

• The nurse is doing discharge teaching with a patient who is going home with an implantable cardioverter-defibrillator (ICD). Which of the

following instructions should the nurse give the patient?

• Keep the incision dry for at least 2 weeks after ICD insertion.
• The ICD will not set off a metal detector in an airport, so it is all right to travel.
• You should have a routine ICD check every 2 to 3 months.
• It is all right to drive as soon as you are discharged

C