Deck 29: Coordinating Care for Patients With Cardiac Dysrhythmia

Question 1

The nurse is observed marching out the rhythm on a patient's cardiac monitor tracing.What is this nurse assessing?

A) Rate
B) Polarity
C) Regularity
D) Amplitude

Answer 1

Regularity

Question 2

A patient's heart rate is 48 beats per minute.Which structure is most likely generating this heart rate?

A) Purkinje fibers
B) Sinoatrial node
C) Atrioventricular node
D) Ventricular pacer cells

Answer 2

Atrioventricular node

Question 3

A patient with atrial fibrillation has a heart rate of 90 beats per minute.Which manifestation should the nurse expect to assess in this patient?

A) Headache
B) Chest pain
C) Palpitations
D) Hypotension

Answer 3

Palpitations

Question 4

A patient's cardiac rhythm has no identifiable P or QRS waves.What action should the nurse take first?

A) Apply oxygen
B) Assess a radial pulse
C) Insert an intravenous line
D) Begin chest compressions

Question 5

The nurse notes that PR intervals are getting progressively longer before a QRS complex is dropped on a patient's cardiac rhythm strip.Which health problem should the nurse realize this patient is experiencing?

A) Mobitz I
B) Mobitz II
C) First-degree AV block
D) Third-degree AV block

Question 6

A patient with atrial fibrillation is being considered for cardioversion.Which diagnostic test should the nurse anticipate being prescribed prior to this procedure being completed?

A) Chest x-ray
B) CT scan of the chest
C) 12-lead electrocardiogram
D) Transesophageal echocardiogram (TEE)

Question 7

A patient is in normal sinus rhythm with prolonged PR intervals.What treatment should the nurse expect to be prescribed for this patient?

A) Continue to monitor
B) Anticipate defibrillating
C) Prepare for cardioversion
D) Prepare for pacemaker insertion

Question 8

The nurse notes that a patient with a cardiac dysrhythmia is developing shortness of breath.What is the pathophysiological reason for this manifestation?

A) Decreased oxygen in the brain
B) Stimulation of the sympathetic nervous system
C) Imbalance in myocardial oxygen demand and supply
D) Increase in oxygenation because of a drop in cardiac output

Question 9

A patient is admitted for treatment for a low junctional rhythm.Where should the nurse expect to assess the P wave on this patient's electrocardiogram?

A) Prior to the QRS wave
B) Buried within the QRS wave
C) At the tail end of the QRS wave
D) Superimposed over the previous T wave

Question 10

A patient with shortness of breath has a heart rhythm of 46 beats per minute.Which medication should the nurse anticipate being prescribed for this patient?

A) Atropine sulfate
B) Atenolol (Tenormin)
C) Diltiazem (Cardizem)
D) Adenosine (Adenocard)

Question 11

When analyzing a patient's electrocardiogram,the nurse notes that the P wave is normal.What criteria did the nurse use to make this decision?

A) Pointed and skinny in width
B) Small and rounded in lead II
C) Upright and rounded in lead II
D) Length 0.10 seconds and height 2.5 mm

Question 12

A patient is being evaluated for a blockage in the cardiac ventricles.On which part of the electrocardiogram should the nurse focus as evidence of this blockage?

A) T wave
B) U wave
C) PR interval
D) QRS interval

Question 13

A patient is experiencing supraventricular tachycardia.What should be done before determining this patient's treatment?

A) Assess for thyroid disease
B) Identify the underlying rhythm
C) Evaluate serum electrolyte values
D) Study lifestyle and behavioral habits

Question 14

A patient with a cardiac dysrhythmia is experiencing nausea and vomiting.What is the reason for this to occur?

A) Poor contractile function
B) Altered electrolyte levels
C) Blood shunted away from nonessential organ systems
D) An imbalance in myocardial oxygen supply and demand

Question 15

A patient is being prepared for a transvenous pacemaker.What should the nurse include when explaining this pacemaker to the family?

A) "It is inserted using an internal jugular vein."
B) "It is done by placing defibrillator pads on the torso using an anterior/posterior position."
C) "It is done by placing a pacer wire in the atrium or the ventricle and fed out through the skin,where it is attached to an external pacemaker."
D) "It is inserted by placing pacer wires in the atrium,ventricle,or both and attached to a small pacemaker generator placed under the skin near the clavicle."

Question 16

A patient is diagnosed with third-degree AV block.For which type of pacemaker should the nurse prepare this patient?

A) Transvenous
B) Biventricular
C) Transthoracic
D) Transcutaneous

Question 17

The nurse is concerned that a patient is at risk for pulseless electrical activity.What information from the assessment did the nurse use to make this clinical decision?

A) Blood pH 7.30
B) Temperature 100.5^°F
C) Serum glucose level 170 mg/dL
D) Serum potassium level 4.1 mEq/L

Question 18

A patient is being cardioverted for symptomatic atrial fibrillation.At which point of the cardiac cycle will the electric impulse occur?

A) At the end of the P wave
B) Before the QRS complex
C) At the peak of the R wave
D) After the QRS complex but before the T wave

Question 19

The nurse is preparing to defibrillate a patient.Which setting should the nurse use for this treatment?

A) 50 J
B) 100 J
C) 150 J
D) 200 J

Question 20

A patient asks why cardiac leads are being placed on the chest.What should the nurse respond to this patient?

A) "It shows where the heart vessels are blocked."
B) "It is used to evaluate the effectiveness of dietary changes."
C) "It provides a graphic picture of the heart's electrical activity."
D) "It determines which medications are needed to improve heart function."

Question 21

A patient with a cardiac dysrhythmia asks why it is important to recognize the signs of a stroke.What should the nurse respond to this patient?

A) "So you can respond quickly and prevent adverse effects."
B) "To encourage you to take your medication as prescribed."
C) "So that you can recognize the signs of stroke in a family member."
D) "Most people with a heart arrhythmia develop strokes as a side effect."

Question 22

During a home visit the nurse learns that a patient has been skipping doses of antiarrhythmic medication.What should the nurse include when counseling this patient?

A) Taking the medication as prescribed reduces the occurrence of side effects
B) Skipping doses increases the risk of developing chest pain and diaphoresis.
C) Adequate medication level decreases the adverse effects of the dysrhythmia.
D) Insufficient amounts of medication in the blood stream affect pacemaker functioning.