Question 1

A patient who is on the progressive care unit develops atrial flutter,rate 150,with associated dyspnea and chest pain.Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

Accepted Answer

Because this patient has dyspnea and chest pain in association with the new rhythm,the nurse's initial actions should be to address the patient's airway,breathing,and circulation (ABC)by starting with oxygen administration.The other actions also are important and should be implemented rapidly.

Question 2

Which action by a new registered nurse (RN)who is orienting to the progressive care unit indicates a good understanding of the treatment of cardiac dysrhythmias?

Accepted Answer

Adenosine must be given over 1 to 2 seconds to be effective.The other actions indicate a need for more education about treatment of cardiac dysrhythmias.The RN should hold the diltiazem until talking to the health care provider.The treatment for asystole is immediate CPR.The synchronizer switch should be "off" when defibrillating.

Question 3

A 19-year-old student comes to the student health center at the end of the semester complaining that,"My heart is skipping beats." An electrocardiogram (ECG)shows occasional premature ventricular contractions (PVCs).What action should the nurse take next?

Accepted Answer

In a patient with a normal heart,occasional PVCs are a benign finding.The timing of the PVCs suggests stress or caffeine as possible etiologic factors.It is unlikely that the patient has coronary artery disease,and this should not be the first question the nurse asks.The patient is hemodynamically stable,so there is no indication that the patient needs to be seen in the ED or that oxygen needs to be administered.

Question 4

When analyzing an electrocardiographic (ECG)rhythm strip of a patient with a regular heart rhythm,the nurse counts 30 small blocks from one R wave to the next.The nurse calculates the patient's heart rate as ____.

Accepted Answer

The answer of When analyzing an electrocardiographic (ECG)rhythm strip of...

Question 5

When preparing to defibrillate a patient.In which order will the nurse perform the following steps? (Put a comma and a space between each answer choice [A,B,C,D,E].)
A) Turn the defibrillator on.
B) Deliver the electrical charge.
C) Select the appropriate energy level.
D) Place the paddles on the patient's chest.
E) Check the location of other staff and call out "all clear."

Accepted Answer

The answer of When preparing to defibrillate a patient.In which...

Question 6

A patient reports dizziness and shortness of breath for several days.During cardiac monitoring in the emergency department (ED),the nurse obtains the following electrocardiographic (ECG)tracing.

The nurse interprets this heart rhythm as

Accepted Answer

The inconsistency between the atrial and ventricular rates and the variable P-R interval indicate that the rhythm is third-degree AV block.Sinus rhythm with PACs will have a normal rate and consistent P-R intervals with occasional PACs.An accelerated idioventricular rhythm will not have visible P waves.

Question 7

A patient who is complaining of a "racing" heart and feeling "anxious" comes to the emergency department.The nurse places the patient on a heart monitor and obtains the following electrocardiographic (ECG)tracing.

Which action should the nurse take next?

Accepted Answer

The patient has sinus tachycardia,which may have multiple etiologies such as pain,dehydration,anxiety,and myocardial ischemia.Further assessment is needed before determining the treatment.Vagal stimulation or b-blockade may be used after further assessment of the patient.Electrical cardioversion is used for some tachydysrhythmias,but would not be used for sinus tachycardia.

Question 8

Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin?

Accepted Answer

A patient with fainting episodes is at risk for falls.The nurse will plan to minimize the risk by having assistance whenever the patient up.The other actions may be needed if dysrhythmias are found to be the cause of the patient's syncope,but are not appropriate for syncope of unknown origin.

Question 9

The nurse has received change-of-shift report about the following patients on the progressive care unit.Which patient should the nurse see first?

Accepted Answer

The frequent firing of the ICD indicates that the patient's ventricles are very irritable,and the priority is to assess the patient and administer the amiodarone.The other patients may be seen after the amiodarone is administered.

Question 10

A patient whose heart monitor shows sinus tachycardia,rate 132,is apneic and has no palpable pulses.What is the first action that the nurse should take?

Accepted Answer

The patient's clinical manifestations indicate pulseless electrical activity and the nurse should immediately start CPR.The other actions would not be of benefit to this patient.

Question 11

Which nursing action can the registered nurse (RN)delegate to experienced unlicensed assistive personnel (UAP)working as a telemetry technician on the cardiac care unit?

Accepted Answer

UAP serving as telemetry technicians can monitor cardiac rhythms for individuals or groups of patients.Nursing actions such as assessment and choice of the most appropriate lead based on ST segment elevation location require RN-level education and scope of practice.

Quiz 36: Nursing Management: Dysrhythmias

A patient who is on the progressive care unit develops atrial flutter,rate 150,with associated dyspnea and chest pain.Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

Which action by a new registered nurse (RN) who is orienting to the progressive care unit indicates a good understanding of the treatment of cardiac dysrhythmias?

A 19-year-old student comes to the student health center at the end of the semester complaining that,"My heart is skipping beats." An electrocardiogram (ECG) shows occasional premature ventricular contractions (PVCs) .What action should the nurse take next?

When analyzing an electrocardiographic (ECG)rhythm strip of a patient with a regular heart rhythm,the nurse counts 30 small blocks from one R wave to the next.The nurse calculates the patient's heart rate as ____.

A patient reports dizziness and shortness of breath for several days.During cardiac monitoring in the emergency department (ED) ,the nurse obtains the following electrocardiographic (ECG) tracing. The nurse interprets this heart rhythm as

A patient who is complaining of a "racing" heart and feeling "anxious" comes to the emergency department.The nurse places the patient on a heart monitor and obtains the following electrocardiographic (ECG) tracing. Which action should the nurse take next?

Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin?

The nurse has received change-of-shift report about the following patients on the progressive care unit.Which patient should the nurse see first?

A patient whose heart monitor shows sinus tachycardia,rate 132,is apneic and has no palpable pulses.What is the first action that the nurse should take?

Which nursing action can the registered nurse (RN) delegate to experienced unlicensed assistive personnel (UAP) working as a telemetry technician on the cardiac care unit?