Deck 9: Basic Cardiac Rhythm Monitoring

Question 1

A patient has been prescribed flecainide (Tambocor)for treatment of ventricular dysrhythmia.Which finding should the nurse discuss with the prescriber prior to initiating this therapy?

A)The patient has lost 6 pounds since hospital admission.
B)The patient experienced nausea while taking digoxin (Lanoxin)many years ago.
C)The patient's urine output was 20 mL over the last hour.
D)The patient's potassium level is 4.8 mEq/dL this morning.

Answer 1

The patient's potassium level is 4.8 mEq/dL this morning.

Question 2

A patient is having multifocal premature ventricular contractions (PVCs).What nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Administer oxygen.
B)Withhold the next digoxin dose.
C)Administer atropine.
D)Monitor the patient closely for other dysrhythmias.
E)Consult with the healthcare provider.

Answer 2

Administer oxygen.
Monitor the patient closely for other dysrhythmias.
Consult with the healthcare provider.

Question 3

A patient's admission vital signs were blood pressure 128/64 mmHg; heart rate 86 beats per minute,respirations 16,and temperature 98.6°F.The patient has spiked a temperature of 101.6°F.Which change in heart rate would the nurse anticipate?

A)Increase to 116 beats per minute
B)Increase to 100 beats per minute
C)Decrease to 76 beats per minute
D)Increase or decrease of no more than 5 beats per minute

Answer 3

Increase to 116 beats per minute

Question 4

A patient has a normal QRS complex on an electrocardiogram,which is followed by the P wave.Heart rate is 80 beats per minute and regular and the patient has no complaints.What nursing action is indicated?

A)Document presence of atrial escape rhythm.
B)Review the patient's medication history.
C)STAT page the patient's healthcare provider.
D)Notify the nurse manager that it may become necessary to call the rapid response team.

Question 5

A patient's electrocardiogram ST segment tracing is deflected from baseline.The nurse would conduct assessment for which condition?

A)Ventricular muscle injury
B)Atrial muscle injury
C)Respiratory acidosis
D)Hypocalcemia

Question 6

A patient's cardiac monitor reveals a regular rhythm with a rate of 240 beats per minute.No P waves are distinguishable.The patient is alert and says,"My heart is racing." What nursing intervention is indicated?

A)Gather equipment to begin anticoagulant therapy.
B)Defibrillate the patient.
C)Prepare the patient for immediate cardioversion.
D)Ask the patient to bear down as if moving the bowels.

Question 7

A patient in the emergency department has a cardiac rhythm strip that reveals a junctional rhythm with rate of 128,PR interval of 0.08 seconds,a normally configured QRS,and an upright T wave.The patient is awake and alert with warm,dry skin.Which nursing intervention is indicated?

A)Prepare for immediate cardioversion
B)Immediate notification of the rapid response team
C)Continued monitoring and assessment
D)Administration of potassium by slow intravenous infusion

Question 8

The nurse has determined that the patient has a bundle branch block.Which condition likely exists?

A)A PR interval longer than 0.20 seconds
B)An elevated ST segment
C)A QRS segment longer than 0.12 seconds
D)A PR interval that lengthens with each beat

Question 9

A patient is diagnosed with hypermagnesemia.The nurse would assess for which changes on the patient's cardiac rhythm strip? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Prolonged QT interval
B)Tachycardia
C)Narrow,upright QRS
D)Atrioventricular (AV)block
E)Prolonged PR interval

Question 10

The nurse interpreting a patient's electrocardiogram has just examined the P waves.What is the nurse's next step?

A)Determine if each P wave is followed by a QRS complex.
B)Measure the PR interval.
C)Diagnose the rhythm.
D)Examine and measure the QRS complex.

Question 11

The nurse notes this rhythm on the patient's cardiac monitor.What is the nurse's priority intervention?

A)Check the patient's pulse.
B)Administer oxygen.
C)Call a code blue.
D)Prepare to cardiovert the patient.

Question 12

A patient develops ventricular tachycardia on the cardiac monitor.The patient says,"My heart is racing" as the nurse determines a rapid pulse is present.What is the nurse's priority intervention?

A)Call respiratory therapy to prepare a mechanical ventilator.
B)Draw blood for arterial blood gases.
C)Prepare for a change in intravenous fluid being administered.
D)Monitor the patient for loss of consciousness.

Question 13

A patient's atrial fibrillation has been refractory to treatment.The nurse would prioritize which discharge instructions?

A)Avoiding stressful situations
B)Anticoagulant therapy precautions
C)The importance of daily weights
D)How to check blood pressure at home

Question 14

A patient has a new onset of a left bundle branch block (LBBB)seen on a 12-lead ECG.What is the nurse's primary intervention?

A)Increase oxygen.
B)Elevate the head of the bed to a 30-degree angle.
C)Ask the patient if he is having chest pain.
D)Reposition the chest leads and assess for any changes.

Question 15

A patient's cardiac monitor frequently sounds false rate alarms.Which nursing intervention is indicated?

A)Ask the patient to lie still.
B)Adjust the high and low rates on the alarm.
C)Shut the room door so the alarm will not disturb other patients.
D)Set the alarms on silent.

Question 16

A patient with a temporary pacemaker has this cardiac rhythm.What nursing intervention is indicated?

A)Turn the impulse generator off,wait 30 seconds,and turn it back on.
B)Call for a STAT portable chest x-ray.
C)Check for a damaged lead wire.
D)Decrease the pacemaker sensitivity.

Question 17

A patient presents to the emergency department and says,"I am so dizzy that it is scaring me." Monitoring reveals the patient's blood pressure is 78/52 mmHg and heart rate is 44 beats per minutes.Which nursing intervention is indicated?

A)Administer antianxiety medication.
B)Administer atropine.
C)Instruct the patient to cough forcefully.
D)Monitor the patient while contacting the primary care provider.

Question 18

A patient has been diagnosed with premature ventricular contractions.The nurse realizes that this dysrhythmia can result from a weaker than normal stimulus during which action potential period?

A)Absolute refractory period
B)Relative refractory period
C)Supranormal period
D)Subnormal period

Question 19

A patient in the emergency department has a heart rate of 140 beats per minute.Which nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Assess the patient's temperature.
B)Administer atropine.
C)Present a calm demeanor.
D)Assess the patient for pain.
E)Prepare for intubation.

Question 20

A patient's cardiac monitor reveals heart rate of 40 beats per minute with an irregular rate.The PR intervals are constant and there are P waves with no QRS to follow.The QRS complexes are wider than normal.The patient complains of severe dizziness and nausea.Which nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Administer atropine.
B)Prepare to cardiovert the patient.
C)Prepare for placement of a temporary pacemaker.
D)Administer epinephrine.
E)Ask the patient to cough forcefully.