Deck 26: Caring for Clients With Cardiac Dysrhythmias

Question 1

You are caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?

A) Defibrillation
B) Mace procedure
C) Pacemaker implantation
D) Elective cardioversion

Answer 1

Elective cardioversion

Question 2

What drug is used for ventricular dysrhythmias?

A) Isoprel
B) Cordarone
C) Tambocor
D) Bretylol

Answer 2

Tambocor

Question 3

The nurse is caring for a client with dysrhythmia. What would be an important procedure to teach a client with dysrhythmia to perform to evaluate his or her response to treatment?

A) Technique for monitoring drug toxicity
B) Technique for palpating and counting the radial pulse
C) Technique for monitoring cardiac response
D) Technique for monitoring blood pressure

Answer 3

Technique for palpating and counting the radial pulse

Question 4

The nurse is caring for a client who has just been diagnosed with sinus bradycardia. The client asks the nurse to explain what sinus bradycardia is. What would be the nurse's best explanation?

A) In many clients a heart rate slower than 60 beats per minute is considered to slow to maintain an adequate cardiac output.
B) Sinus bradycardia means your heart is not beating fast enough to keep you alive.
C) Sinus bradycardia is nothing to worry about.
D) In many clients a heart rate slower than 70 beats per minute is considered to slow to maintain an adequate cardiac output.

Question 5

What nursing interventions could you institute with a client who has a suspected dysrhythmia that would help detect life-threatening dysrhythmias and would manage and minimize any that occur?

A) Monitor blood pressure continuously.
B) Monitor cardiac rhythm continuously.
C) Provide supplemental oxygen.
D) Palpate the client's pulse and observe the client's response.

Question 6

Elective cardioversion is similar to defibrillation except that the electrical stimulation waits to discharge until an R wave appears. What does this prevent?

A) Disrupting the heart during the critical period of atrial repolarization.
B) Disrupting the heart during the critical period of ventricular repolarization.
C) Disrupting the heart during the critical period of ventricular depolarization.
D) Disrupting the heart during the critical period of atrial depolarization.

Question 7

You are taking a pre-nursing pharmacology class. Today you are learning about anti-dysrhythmic drugs. What drug is a potassium channel blocker?

A) Cordarone
B) Lidacaine
C) Tambocor
D) Isoprel

Question 8

You are caring for a client who is in sinus bradycardia. Atropine sulfate has been ordered. What would be an appropriate IV dose ofAtropine sulfate if given every 1 to 2 hours?

A) 0.25 to 0.5 mg
B) 0.5 to 1 mg
C) 1 mg to 1.5 mg
D) 1.5 mg. to 2 mg

Question 9

The staff educator is presenting a class on cardiac dysrhythmias. How would the educator describe the characteristic pattern of the atrial waves in atrial flutter?

A) Sinusoidal
B) Triangular
C) Sawtooth
D) Square

Question 10

Your client has been diagnosed with an atrial dysrhythmia. The client has come to the clinic for a follow-up appointment and to talk with the physician about options to stop this dysrhythmia. What would be a procedure used to treat this client?

A) Elective electrical cardioversion
B) Chemical cardioversion
C) Mace procedure
D) Elective electrical defibrillation

Question 11

You are caring for a client who has been admitted to have a cardioverter defibrillator implanted. You would know that implanted cardioverter defibrillators are used in what clients?

A) Clients with recurrent life-threatening bradycardias
B) Clients with sinus tachycardia
C) Clients with ventricular bradycardia
D) Clients with recurrent life-threatening tachydysrhythmias

Question 12

You enter your client's room and find them pulseless and unresponsive. What would be the treatment of choice for this client?

A) IV lidocaine
B) Chemical cardioversion
C) Immediate defibrillation
D) Electric cardioversion

Question 13

The nursing instructor is teaching a class in drugs used for dysrhythmias. What would the instructor teach as a required nursing intervention when administering the prescribed cholinergic antagonists to a client with dysrhythmia?

A) Keep life support equipment available.
B) Keep client recumbent.
C) Document heart rate before and after administration.
D) Keep client flat for 1 hour after administration.

Question 14

You are caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?

A) Fluttering
B) Nausea
C) Hypotension
D) Fever

Question 15

A pacemaker is the treatment of choice for what cardiac dysrhythmia?

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

Question 16

Your client has just been diagnosed with a dysrhythmia. The client asks you to explain normal sinus rhythm. What would you explain are the characteristics of normal sinus rhythm?

A) Heart rate between 60 and 150 beats per minute.
B) Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 seconds.
C) The ventricles depolarize in 0.5 seconds or less.
D) The sinoatrial (SA) node initiates the impulse.

Question 17

The staff educator is teaching a class in dysrhythmias. What statement is correct for defibrillation?

A) It is a scheduled procedure 1 to 10 days in advance.
B) The client is sedated before the procedure.
C) It is used to eliminate ventricular dysrhythmias.
D) It uses less electrical energy than cardioversion.

Question 18

A client with atrial fibrillation, who does not respond to conventional treatment measures and who is not a candidate for cardioversion, would have what procedure recommended?

A) Angiography
B) Maze procedure
C) Open heart surgery
D) Heart transplantation

Question 19

Your client has just been prescribed Pronestyl for their dysrhythmia. What would you teach this client about the side effects?

A) Hypertension
B) Decreased appetite
C) Change in mental status
D) GI upset

Question 20

You are caring for a client who has had an automatic cardiac defibrillator implanted. What instructions should you provide your client?

A) Avoid devices with a magnetic field.
B) Use digital cellular telephones.
C) Avoid driving for at least 3 months.
D) Avoid using microwave ovens.

Question 21

The nursing instructor is discussing pacemakers with her clinical group. One of the students is caring for a client with a transvenous pacemaker. One of the students asks why this client has a transvenous pacemaker. What would be the instructor's best response?

A) "A transvenous pacemaker is used in place of a transarterial pacemaker."
B) "A transvenous pacemaker is a permanent pacemaker that is asynchronous."
C) "A transvenous pacemaker is used for a ventricular tachyarrhythmia."
D) "A transvenous pacemaker is used to manage transient bradydysrhythmias like those that occur during acute MIs."

Question 22

You are an operating room nurse caring for a client who is having a pacemaker implanted. The physician has requested a demand mode pacemaker for this client. What is this type of pacemaker?

A) A fixed-rate pacemaker
B) A temporary pacemaker
C) Self-activated
D) Asynchronous

Question 23

Your client has just been admitted with bradycardia and scheduled for the insertion of a pacemaker. You notify the physician that the client's heart rate has dropped into the 40 beats per minute range. The physician orders a temporary pacemaker. You know that there are different types of temporary pacemakers. What types of temporary pacemakers are there? Select all that apply.

A) Transatrial
B) Transcutaneous
C) Transvenous
D) Transthoracic
E) Transabdominal

Question 24

You are caring for a client who is scheduled to have an automatic implanted cardioverter defibrillator (AICD) implanted. Which clients are candidates for AICD implantation? Select all that apply.

A) Clients who have experienced recurrent episodes of ventricular tachycardia.
B) Clients who have survived at least one episode of cardiac arrest from a ventricular dysrhythmia.
C) Clients who have had a Maze procedure that has been unsuccessful.
D) Clients who are at risk for sudden cardiac death due to structural heart disease.
E) Clients who have recurrent episodes of ventricular bradycardia.

Question 25

Your client has returned to the floor with a transthoracic pacemaker ready to be connected. You know that a transthoracic pacemaker is a temporary pacemaker used in what situation?

A) Transthoracic pacemakers are used in a client who has had open-heart surgery.
B) Transthoracic pacemakers are used when a client has an MI.
C) Transthoracic pacemakers are used after a coronary bypass graft surgery.
D) Transthoracic pacemakers are used for tachyarrhythmias.