Deck 25: Nursing Care of Patients With Cardiac Dysrhythmias

Question 1

After reviewing an electrocardiogram the nurse determines that an electrical impulse originated in a patient's the sinoatrial node.What did the nurse see on this tracing?

A) An upright T wave
B) An inverted T wave
C) A positive P wave before a QRS complex
D) A negative P wave before a QRS complex

Answer 1

A positive P wave before a QRS complex

Question 2

A patient is in sustained ventricular tachycardia.Which dysrhythmia should the nurse realize can occur if the ventricular tachycardia is not treated?

A) Atrial flutter
B) Atrial fibrillation
C) Complete heart block
D) Ventricular fibrillation

Answer 2

Ventricular fibrillation

Question 3

The nurse is assessing a patient's apical heart rate.Which heart rate should the nurse document as tachycardia?

A) 80 beats/min
B) 90 beats/min
C) 100 beats/min
D) 110 beats/min

Answer 3

110 beats/min

Question 4

A patient is admitted for diagnosis of an electrocardiogram abnormality.Which wave should the nurse plan care based upon changes in the patient's ventricular depolarization?

A) P wave
B) QRS complex
C) U wave
D) T wave

Question 5

The nurse is caring for a patient who develops sinus tachycardia.What action should the nurse take?

A) Inform the RN promptly.
B) Turn the patient onto the left side.
C) Recheck vital signs in 15 minutes.
D) Have the patient cough forcefully.

Question 6

The nurse is teaching a patient what complications to report with a pacemaker rate set at 72 beats/minute.Which patient response indicates that further teaching is necessary?

A) "A pulse of 74 is still considered safe."
B) "Any pulse rate over 60 is considered adequate."
C) "If my pulse is 90, then I should notify the doctor."
D) "My pulse rate will most likely be 72 when I take it."

Question 7

The nurse is reinforcing teaching for a patient with premature ventricular contractions (PVCs)and is being discharged.Which lifestyle recommendation should be the most important for the nurse to include?

A) "It is important for you to drink decaffeinated beverages."
B) "You should increase the amount of exercise you do each day."
C) "It is important for you to reduce the amount of fat in your diet."
D) "Weight gain and fluid retention are likely causing your abnormal heart rhythm."

Question 8

A patient is diagnosed with ventricular fibrillation.For which emergency intervention should the nurse anticipate preparing?

A) Defibrillation
B) Endotracheal Intubation
C) Synchronized cardioversion
D) Cardiopulmonary resuscitation (CPR)

Question 9

The nurse is reinforcing teaching for a patient who has had a pacemaker implanted in the right side of the chest.Which patient statement indicates correct understanding of the discharge teaching?

A) "I may lift 20 pounds safely."
B) "I may move my arm freely."
C) "I may resume normal activity in 1 week."
D) "Grounded microwave ovens may be safely used."

Question 10

The nurse is participating in the emergency care for a patient who is in ventricular fibrillation.Which manifestation should the nurse expect to find and document during data collection?

A) Dyspnea
B) Pinpoint pupils
C) Absent peripheral pulses
D) Capillary refill less than 3 seconds

Question 11

A patient on cardiac telemetry has F waves present.Which entry should the nurse include in the documentation?

A) "Atrial fibrillation noted"
B) "Ventricular fibrillation present"
C) "Atrial flutter present on telemetry"
D) "Premature ventricular contractions noted"

Question 12

The nurse is reviewing a patient's electrocardiogram.Which wave should the nurse recognize as being the first positive wave in a normal cardiac cycle?

A) P wave
B) Q wave
C) R wave
D) S wave

Question 13

A patient is diagnosed with a disorder affecting the P wave within the cardiac cycle.The nurse should plan care to address which cardiac action?

A) Atrial repolarization
B) Atrial depolarization
C) Ventricular repolarization
D) Ventricular depolarization

Question 14

A patient has a pacemaker set at 72 beats/min.The nurse obtains a heart rate of 62 beats/min.What action should the nurse take?

A) Review pacemaker documentation.
B) Palpate and observe the generator site.
C) Administer the patient's scheduled digoxin dose.
D) Notify the registered nurse (RN) to inform the physician.

Question 15

A patient is experiencing electrocardiogram changes.Which wave should the nurse recognize as representing ventricular repolarization?

A) Q wave
B) R wave
C) S wave
D) T wave

Question 16

The nurse is reinforcing teaching for a patient who has a pacemaker.Which measure should the nurse include when explaining how the pulse should be monitored?

A) Take radial pulse for 1 minute.
B) Take apical pulse for 1 minute.
C) Take jugular pulse for 30 seconds.
D) Take brachial pulse for 30 seconds.

Question 17

A patient is having an electrocardiogram.Which wave should the nurse identify as being the first negative wave after a P wave in a normal cardiac cycle?

A) Q wave
B) R wave
C) S wave
D) T wave

Question 18

A patient scheduled for magnetic resonance imaging (MRI)has an implanted pacemaker.What should the nurse anticipate being done for this patient?

A) MRI will take longer than usual.
B) MRI is contraindicated for this patient.
C) The pacemaker settings will be adjusted.
D) The patient will be given sedation before MRI.

Question 19

The nurse is reviewing a patient's electrocardiogram.Which wave should the nurse identify as being the second positive wave in a normal cardiac cycle?

A) Q wave
B) R wave
C) S wave
D) T wave

Question 20

The nurse is reviewing cardiac anatomy with a patient scheduled for pacemaker insertion.Where should the nurse identify the location of the sinus node for the patient?

A) Left atrium
B) Right atrium
C) Left ventricle
D) Right ventricle

Question 21

While assessing vital signs the nurse determines the regularity of a patient's cardiac rhythm.Which cardiac cycle measurement will the nurse use regularity to calculate?

A) Heart rate
B) ST segment
C) P-R interval
D) QRS interval

Question 22

The nurse is contributing to a patient's teaching plan after a pacemaker implantation.Which potential complications should be included in the patient's teaching plan? (Select all that apply.)

A) Fainting
B) Embolism
C) Palpitations
D) Hemorrhage
E) Pulmonary edema
F) Infection at the site

Question 23

The nurse calculates a patient's QRS interval as being 0.08 seconds.What should the nurse do for this patient?

A) Consider starting CPR.
B) Notify the RN immediately.
C) Prepare to defibrillate the patient.
D) Nothing since this is a normal finding.

Question 24

The nurse notices that the ST segment is depressed on a patient reporting chest pain.What action should the nurse take?

A) Review the ECG recordings in the patient's chart.
B) Auscultate chest sounds, and continue physical assessment.
C) Alert the supervising RN and patient's physician immediately.
D) Continue to monitor the electrocardiogram (ECG) to determine if ST segment depression continues.

Question 25

The nurse is instructing a patient with an implantable cardioverter defibrillator (ICD)on cell phone use.How many inches should the nurse instruct the patient to keep the cell phone from the ICD?

A) 2
B) 4
C) 6
D) 8

Question 26

The nurse observes two PACs in 1 minute on a patient's cardiac monitor.The patient is asymptomatic.What action is required by the nurse?

A) Administer digoxin.
B) Notify the physician.
C) Continue monitoring the patient.
D) Take vital signs every 15 minutes.

Question 27

The nurse is reviewing the electrical activity of the heart with a patient scheduled for synchronized pacing.In which area of the heart should the nurse teach that an electrical impulse travels that originates in the sinus node?

A) Ventricle
B) Bundle of His
C) Purkinje's fibers
D) Atrioventricular node

Question 28

The nurse is conducting a community health screening.Which individual should the nurse recognize as being the highest risk for atrial fibrillation?

A) A 44-year-old obese male with asthma
B) A 62-year-old male smoker with a history of rheumatic heart disease
C) A 56-year-old female with diabetes who has elevated cholesterol levels
D) A 68-year-old female with Parkinson's disease who takes carbidopa-levodopa (Sinemet)

Question 29

The nurse is determining the functioning of a patient's sinoatrial node.How many times per minute should the nurse expect the node to normally fire?

A) 20 to 40
B) 25 to 55
C) 40 to 85
D) 60 to 100

Question 30

A patient has a normal heartbeat of 72 beats per minute.What area of the conduction system should the nurse consider as functioning normally in this patient?

A) Bundle of His
B) Sinoatrial node
C) Purkinje's fibers
D) Atrioventricular node

Question 31

The nurse is seeking assistance for a patient having continuous cardiac monitoring.Which type of PVCs did the nurse most likely observe in this patient?

A) A PVC couplet
B) A unifocal PVC
C) R-on-T phenomenon
D) Less than six PVCs per minute

Question 32

A patient recovering from an acute myocardial infarction has a heart rate of 30 beats per minute.Which area of the heart should the nurse consider as pacing this patient's heart rate?

A) Sinoatrial node
B) Ventricular rate
C) Aortic valve rate
D) Atrioventricular node

Question 33

While assisting in a code,the nurse recognizes a pattern of ventricular fibrillation on the cardiac monitor.Which should the nurse expect to be ordered next?

A) Defibrillation
B) Hyperoxygenation
C) Intravenous (IV) digoxin
D) IV atropine

Question 34

A patient is diagnosed with atrial fibrillation.Which characteristics of this rhythm should the nurse expect to observe on this patient's cardiac monitor? (Select all that apply.)

A) Smooth P waves
B) Irregular rhythm
C) F waves with sawtooth pattern
D) PR interval 0.12 to 0.20 second
E) QRS complex not more than 0.10 second
F) Abnormal beat alternates with normal beat in a 1:1 ratio

Question 35

A patient is prescribed to have a 12-lead ECG completed.How many views of the patient's heart will this ECG provide?

A) 6
B) 12
C) 18
D) 24

Question 36

The nurse is reinforcing discharge teaching for a patient who has had a permanent pacemaker inserted.What is important for the nurse to include? (Select all that apply.)

A) Patient should avoid all grounded appliances.
B) Patient should wear medical alert identification.
C) Patient should avoid magnetic fields and high voltage.
D) Patient should avoid lifting anything more than 10 pounds.
E) Patient may return to normal activities, including sports, in 3 weeks.
F) Patient should report dizziness, irregular heartbeats, and palpitations.

Question 37

The nurse is analyzing a patient's electrocardiogram.What should the nurse consider as normal for the P-R interval?

A) 0.02 to 0.04 second
B) 0.05 to 0.l0 second
C) 0.12 to 0.20 second
D) 0.21 to 0.30 second

Question 38

A patient is experiencing palpitations that are found to be PVCs.Which manifestation should the nurse expect to observe in this patient?

A) Headache
B) Confusion
C) Lightheadedness
D) Tingling of extremities

Question 39

After analyzing a patient's heart rhythm the nurse determines that the heart rate is 48 beats per minute.How should the nurse document this finding?

A) Sinus tachycardia
B) Sinus bradycardia
C) Ventricular fibrillation
D) Ventricular tachycardia

Question 40

A patient is diagnosed with premature atrial contractions.On which area of the heart should the nurse focus when explaining this disorder to the patient?

A) Atrium
B) Ventricle
C) Bundle of His
D) Atrioventricular node

Question 41

The nurse is analyzing the P waves on a patient's electrocardiogram tracing.For what should the nurse analyze this type of wave? (Select all that apply.)

A) The P waves all look alike.
B) The P waves all have different shapes.
C) The P waves are consistently occurring.
D) A P wave is present in front of every QRS.
E) A P wave is present at the end of every QRS.

Question 42

The nurse is caring for a patient recovering from cardioversion.For what should the nurse monitor in this patient? (Select all that apply.)

A) Skin burns
B) Blood pressure
C) Sensory disturbances
D) Respiratory problems
E) Rhythm disturbances
F) Changes in ST segment

Question 43

The nurse identifies the diagnosis of decreased cardiac output as being appropriate for a patient with an acute dysrhythmia.Which interventions should the nurse include in this patient's plan of care? (Select all that apply.)

A) Monitor radial pulse.
B) Monitor apical pulse.
C) Monitor lung sounds.
D) Monitor level of consciousness.
E) Encourage patient to increase activity level.
F) Observe for adverse reactions to medications.

Question 44

The nurse determines that a patient's electrocardiogram is demonstrating normal sinus rhythm.What did the nurse observe to come to this conclusion? (Select all that apply.)

A) Regular rhythm
B) PR interval 0.16 seconds
C) QRS interval 0.20 seconds
D) Heart rate 88 beats per minute
E) P wave before each QRS complex