Question 1

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)  Instruct the patient to call for assistance before getting out of bed. 
B)  Explain the association between various dysrhythmias and syncope. 
C)  Educate the patient about the need to avoid caffeine and other stimulants. 
D)  Tell the patient about the benefits of implantable cardioverter-defibrillators. 
A)  Instruct the patient to call for assistance before getting out of bed. 
B)  Explain the association between various dysrhythmias and syncope. 
C)  Educate the patient about the need to avoid caffeine and other stimulants. 
D)  Tell the patient about the benefits of implantable cardioverter-defibrillators.

Question 2

The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm.Which method will be best to use?

Accepted Answer

A)  Count the number of large squares in the R-R interval and divide by 300. 
B)  Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes. 
C)  Calculate the number of small squares between one QRS complex and the next and divide into 1500. 
D)  Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10. 
A)  Count the number of large squares in the R-R interval and divide by 300. 
B)  Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes. 
C)  Calculate the number of small squares between one QRS complex and the next and divide into 1500. 
D)  Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10.

Question 3

After the nurse gives IV atropine to a patient with symptomatic type 1,second-degree atrioventricular (AV)block,which finding indicates that the medication has been effective?

Accepted Answer

A)  Increase in the patient's heart rate 
B)  Increase in strength of peripheral pulses 
C)  Decrease in premature atrial contractions 
D)  Decrease in premature ventricular contractions 
A)  Increase in the patient's heart rate 
B)  Increase in strength of peripheral pulses 
C)  Decrease in premature atrial contractions 
D)  Decrease in premature ventricular contractions

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

50
There are 1500 sm

Question 5

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

A)  A patient who is in a sinus rhythm, rate 98, after having electrical cardioversion 2 hours ago 
B)  A patient with new onset atrial fibrillation, rate 88, who has a first dose of warfarin (Coumadin) due 
C)  A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating 
D)  A patient whose implantable cardioverter-defibrillator (IC
D)  fired two times today who has a dose of amiodarone (Cordarone) due 
A)  A patient who is in a sinus rhythm, rate 98, after having electrical cardioversion 2 hours ago 
B)  A patient with new onset atrial fibrillation, rate 88, who has a first dose of warfarin (Coumadin) due 
C)  A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating 
D)  A patient whose implantable cardioverter-defibrillator (IC
D)  fired two times today who has a dose of amiodarone (Cordarone) due

Question 6

The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves,P-R interval not measurable,ventricular rate 162,R-R interval regular,and QRS complex wide and distorted,QRS duration 0.18 second.The nurse interprets the patient's cardiac rhythm as

Accepted Answer

A)  atrial flutter. 
B)  sinus tachycardia. 
C)  ventricular fibrillation. 
D)  ventricular tachycardia. 
A)  atrial flutter. 
B)  sinus tachycardia. 
C)  ventricular fibrillation. 
D)  ventricular tachycardia.

Question 7

A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia,then converts to sinus rhythm with a heart rate of 98 beats/minute.Which of the following actions should the nurse take next?

Accepted Answer

A)  Immediately notify the health care provider. 
B)  Document the rhythm and continue to monitor the patient. 
C)  Perform synchronized cardioversion per agency dysrhythmia protocol. 
D)  Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol. 
A)  Immediately notify the health care provider. 
B)  Document the rhythm and continue to monitor the patient. 
C)  Perform synchronized cardioversion per agency dysrhythmia protocol. 
D)  Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol.

Question 8

A patient has a junctional escape rhythm on the monitor.The nurse will expect the patient to have a heart rate of _____ beats/minute.

Accepted Answer

A)  15 to 20 
B)  20 to 40 
C)  40 to 60 
D)  60 to 100 
A)  15 to 20 
B)  20 to 40 
C)  40 to 60 
D)  60 to 100

Question 9

Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?

Accepted Answer

A)  The procedure will prevent or minimize the risk for sudden cardiac death. 
B)  The procedure will use cold therapy to stop the formation of the flutter waves. 
C)  The procedure will use electrical energy to destroy areas of the conduction system. 
D)  The procedure will stimulate the growth of new conduction pathways between the atria. 
A)  The procedure will prevent or minimize the risk for sudden cardiac death. 
B)  The procedure will use cold therapy to stop the formation of the flutter waves. 
C)  The procedure will use electrical energy to destroy areas of the conduction system. 
D)  The procedure will stimulate the growth of new conduction pathways between the atria.

Question 10

The nurse notes that a patient's cardiac monitor shows that every other beat is earlier than expected,has no visible P wave,and has a QRS complex that is wide and bizarre in shape.How will the nurse document the rhythm?

Accepted Answer

A)  Ventricular couplets 
B)  Ventricular bigeminy 
C)  Ventricular R-on-T phenomenon 
D)  Multifocal premature ventricular contractions 
A)  Ventricular couplets 
B)  Ventricular bigeminy 
C)  Ventricular R-on-T phenomenon 
D)  Multifocal premature ventricular contractions

Question 11

A patient's cardiac monitor shows sinus rhythm,rate 64.The P-R interval is 0.18 seconds at 1:00 AM,0.22 seconds at 2:30 PM,and 0.28 seconds at 4:00 PM.Which action should the nurse take next?

Accepted Answer

A)  Place the transcutaneous pacemaker pads on the patient. 
B)  Administer atropine sulfate 1 mg IV per agency dysrhythmia protocol. 
C)  Document the patient's rhythm and assess the patient's response to the rhythm. 
D)  Call the health care provider before giving the next dose of metoprolol (Lopressor). 
A)  Place the transcutaneous pacemaker pads on the patient. 
B)  Administer atropine sulfate 1 mg IV per agency dysrhythmia protocol. 
C)  Document the patient's rhythm and assess the patient's response to the rhythm. 
D)  Call the health care provider before giving the next dose of metoprolol (Lopressor).

Exam 32: Nursing Management: Ecg Monitoring and Arrhythmias

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 needs to quickly estimate the heart rate for a patient with a regular heart rhythm.Which method will be best to use?

After the nurse gives IV atropine to a patient with symptomatic type 1,second-degree atrioventricular (AV)block,which finding indicates that the medication has been effective?

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 ____.

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 who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia,then converts to sinus rhythm with a heart rate of 98 beats/minute.Which of the following actions should the nurse take next?

A patient has a junctional escape rhythm on the monitor.The nurse will expect the patient to have a heart rate of _____ beats/minute.

Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?

The nurse notes that a patient's cardiac monitor shows that every other beat is earlier than expected,has no visible P wave,and has a QRS complex that is wide and bizarre in shape.How will the nurse document the rhythm?

A patient's cardiac monitor shows sinus rhythm,rate 64.The P-R interval is 0.18 seconds at 1:00 AM,0.22 seconds at 2:30 PM,and 0.28 seconds at 4:00 PM.Which action should the nurse take next?

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