Question 1

A 21-year-old student arrives at the student health center at the end of the quarter complaining that, "My heart is skipping beats." An electrocardiogram ( ECG ) shows occasional premature ventricular contractions ( PVCs ). What action should the nurse take first?

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 2

A patient experiences 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 cardiac 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 or PVCs will have a normal rate and consistent P-R intervals with occasional PACs or PVCs. A junctional escape rhythm will not have P waves.

Question 3

A patient whose cardiac monitor shows sinus tachycardia, rate 102, is apneic and no pulses are palpable by the nurse. 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 4

A patient who is on the telemetry unit develops atrial flutter, rate 150, with associated dyspnea and diaphoresis. Which of these actions that are included in the hospital dysrhythmia protocol should the nurse take first?

Accepted Answer

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

Question 5

When analyzing an electrocardiographic (ECG) rhythm strip of a patient with a regular cardiac rhythm, the nurse finds there are 25 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...

Question 6

A patient who is complaining of a "racing" heart and nervousness comes to the emergency department. The nurse places the patient on a cardiac 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 7

The nurse has received change-of-shift report about the following patients on the telemetry 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 8

When a patient requires defibrillation, in which order will the nurse accomplish the following steps? Put a comma and space between each solve choice (a, b, c, d, etc.) ____________________
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 personnel and call out "all clear."

Accepted Answer

The answer of When a patient requires defibrillation, in which...

Quiz 36: Nursing Management: Dysrhythmias

A 21-year-old student arrives at the student health center at the end of the quarter complaining that, "My heart is skipping beats." An electrocardiogram ( ECG ) shows occasional premature ventricular contractions ( PVCs ) . What action should the nurse take first?

A patient experiences 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 cardiac rhythm as

A patient whose cardiac monitor shows sinus tachycardia, rate 102, is apneic and no pulses are palpable by the nurse. What is the first action that the nurse should take?

A patient who is on the telemetry unit develops atrial flutter, rate 150, with associated dyspnea and diaphoresis. Which of these actions that are included in the hospital dysrhythmia protocol should the nurse take first?

When analyzing an electrocardiographic (ECG) rhythm strip of a patient with a regular cardiac rhythm, the nurse finds there are 25 small blocks from one R wave to the next. The nurse calculates the patient's heart rate as ____________________.

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

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