Deck 25: Nursing Care of Patients With Cardiac Dysrhythmias

Question 1

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

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

Answer 1

"Any pulse rate over 60 is considered adequate."

Question 2

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

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

Answer 2

Take radial pulse for 1 minute.

Question 3

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

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

Answer 3

"Grounded microwave ovens may be safely used."

Question 4

When a patient is in sustained ventricular tachycardia, the nurse understands it can progress to which of these dysrhythmias?

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

Question 5

A patient on cardiac telemetry has F waves present. Which of the following entries would the nurse include in the documentation?

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

Question 6

If the history of a patient who is scheduled for magnetic resonance imaging (MRI) reveals an implanted pacemaker, which of the following should the nurse anticipate?

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 7

Which of these events does a P wave represent?

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

Question 8

Which wave is the second positive wave in a normal cardiac cycle?

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

Question 9

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

Question 10

The nurse is reinforcing teaching for a patient who has had premature ventricular contractions (PVCs) and is being discharged. Which of the following lifestyle recommendations would be most important to include?

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

Question 11

The nurse is participating in the emergency care for a patient who is in ventricular fibrillation. Which of these manifestations would 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 12

Which wave is 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 13

Which wave represents ventricular repolarization?

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

Question 14

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

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

Question 15

What is the best treatment for terminating ventricular fibrillation?

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

Question 16

Which of these waves is the first positive wave in a normal cardiac cycle?

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

Question 17

Which of these waves represents ventricular depolarization?

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

Question 18

Which of these heart rates should the nurse document as tachycardia?

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

Question 19

Which wave indicates that an electrical impulse originated in the sinoatrial node?

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

Question 20

A patient asks, "Where is the sinus node located?" What is the nurse's correct response?

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

Question 21

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

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

Question 22

An electrical impulse that originates in the sinus node travels to which area of the heart?

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

Question 23

Atrial fibrillation has which of the following characteristics? (Select all that apply.?

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

Question 24

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

Question 25

What is the normal 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 26

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

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

Question 27

A premature atrial contraction is a cardiac contraction that originates in which area of the heart?

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

Question 28

Determining the regularity of a rhythm allows use of the most accurate method of calculating which of these cardiac cycle measurements?

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

Question 29

The nurse recognizes that prompt treatment is essential for which type of premature ventricular contractions (PVCs) if viewed on the patient's cardiac monitor?

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

Question 30

Which of the following interventions should the nurse implement for a patient with a nursing diagnosis of decreased cardiac output due to an acute dysrhythmia? (Select all that apply.?

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

Question 31

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

Question 32

For continuous electrocardiogram (ECG) monitoring, lead ________________is often the most commonly used lead.

Question 33

A patient with an implantable cardioverter defibrillator (ICD) should be told to keep cell phones ________________inches from the ICD.

Question 34

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

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

Question 35

Which of the following should the nurse monitor in a patient who has undergone cardioversion? (Select all that apply.?

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

Question 36

The sinoatrial node normally fires at 60 to ________________beats/minute.

Question 37

What area of the conduction system initiates the normal heartbeat?

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

Question 38

While conducting community health screening, the nurse recognizes that which of the following individuals is at highest risk for atrial fibrillation?

A)A 56-year-old female with diabetes who has elevated cholesterol levels
B)A 44-year-old obese male with asthma
C)A 62-year-old male smoker with a history of rheumatic heart disease
D)A 68-year-old female with Parkinson's disease who takes carbidopa-levadopa (Sinemet)
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 39

A patient reports having palpitations that are found to be premature ventricular contractions (PVCs). Which of these manifestations would the nurse likely discover and document during data collection when the patient is having PVCs?

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