Question 1

The patient's heart rhythm shows an inverted P wave with a PR interval of 0.06 seconds.The heart rate is 54 beats per minute.The nurse recognizes the rhythm as a junctional escape rhythm,and understands that the rhythm is due to the:

Accepted Answer

A)  loss of sinus node activity. 
B)  increased rate of the AV node. 
C)  increased rate of the SA node. 
D)  decreased rate of the AV node.

Question 2

The patient is asymptomatic but is diagnosed with second-degree heart block Mobitz I.The patient is on digitalis medication at home.The nurse should expect that:

Accepted Answer

A)  the patient has had an anterior wall myocardial infarction. 
B)  the physician will order the digitalis to be continued in the hospital. 
C)  a digitalis level would be ordered upon admission. 
D)  the patient will require a transcutaneous pacemaker.

Question 3

The patient has a permanent pacemaker inserted.The provider has set the pacemaker to the demand mode at a rate of 60 beats per minute.The nurse realizes that:

Accepted Answer

A)  the pacemaker will pace only if the patient's intrinsic heart rate is less than 60 beats per minute. 
B)  the demand mode often competes with the patient's own rhythm. 
C)  the demand mode places the patient at risk for the R-on-T phenomenon. 
D)  the fixed rate mode is safer and is the mode of choice.

Question 4

The patient is admitted with sinus pauses causing periods of loss of consciousness.The patient is asymptomatic,awake and alert,but fatigued.He answers questions appropriately.When admitting this patient,the nurse should first:

Accepted Answer

A)  prepare the patient for temporary pacemaker insertion. 
B)  prepare the patient for permanent pacemaker insertion. 
C)  assess the patient's medication profile. 
D)  apply transcutaneous pacemaker paddles.

Question 5

Interpret the following rhythm:

Accepted Answer

A)  Idioventricular rhythm 
B)  Accelerated idioventricular rhythm 
C)  Ventricular tachycardia 
D)  Ventricular fibrillation

Question 6

Electrocardiogram (ECG)paper contains a standardized grid where the horizontal axis measures time and the vertical axis measures voltage or amplitude.The nurse must understand that each horizontal box indicates:

Accepted Answer

A)  200 milliseconds or 0.20 seconds duration. 
B)  40 milliseconds or 0.04 seconds duration. 
C)  3 seconds duration. 
D)  millivolts of amplitude.

Question 7

Interpret the following rhythm:

Accepted Answer

A)  Sinus rhythm with multifocal premature ventricular contractions 
B)  Sinus rhythm with unifocal premature ventricular contractions 
C)  Sinus rhythm with bigeminal premature ventricular contractions 
D)  Sinus rhythm with paired premature ventricular contractions (couplets)

Question 8

Interpret the following rhythm:

Accepted Answer

A)  Sinus rhythm with multifocal premature ventricular contractions 
B)  Sinus rhythm with unifocal premature ventricular contractions 
C)  Sinus rhythm with bigeminal premature ventricular contractions 
D)  Sinus rhythm with paired premature ventricular contractions (couplets)

Question 9

The patient is in chronic junctional escape rhythm with no atrial activity noted.Studies have demonstrated normal AV node function.This patient may be a candidate for which type of pacing?

Accepted Answer

A)  Atrial pacing 
B)  Ventricular pacing 
C)  Dual-chamber pacing 
D)  Transcutaneous pacing

Question 10

The patient has an irregular heart rhythm.To determine an accurate heart rate,the nurse first:

Accepted Answer

A)  identifies the markers on the ECG paper that indicate a 6-second strip. 
B)  counts the number of large boxes between two consecutive P waves. 
C)  counts the number of small boxes between two consecutive QRS complexes. 
D)  divides the number of complexes in a 6-second strip by 10.

Question 11

When assessing the 12-lead electrocardiogram (ECG)or a rhythm strip,it is helpful to understand that the electrical activity is viewed in relation to the positive electrode of that particular lead.When an electrical signal is aimed directly at the positive electrode,the inflection will be:

Accepted Answer

A)  negative. 
B)  upside down. 
C)  upright. 
D)  equally positive and negative.

Question 12

Interpret the following rhythm:

Accepted Answer

A)  Normal pacemaker function 
B)  Failure to capture. 
C)  Failure to pace. 
D)  Failure to sense.

Question 13

Interpret the following rhythm:

Accepted Answer

A)  R-on-T phenomenon 
B)  Sinus rhythm with multifocal premature ventricular contractions 
C)  Nonsustained ventricular tachycardia 
D)  Sinus rhythm with bigeminal premature ventricular contractions

Question 14

Interpret the following rhythm:

Accepted Answer

A)  First-degree AV block 
B)  Second-degree AV block Mobitz I (Wenckebach phenomenon) 
C)  Second-degree AV block Mobitz II 
D)  Third-degree AV block (complete heart block)

Question 15

The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and there are no discernible P waves.The ventricular rate is 90 beats per minute,and the patient is hemodynamically stable.The nurse realizes that the patient's rhythm is:

Accepted Answer

A)  atrial fibrillation. 
B)  atrial flutter. 
C)  atrial flutter with rapid ventricular response. 
D)  junctional escape rhythm.

Question 16

The nurse notes the following rhythm on the heart monitor.The patient is unresponsive and not breathing.The nurse should

Accepted Answer

A)  treat with intravenous amiodarone or lidocaine. 
B)  provide emergent basic and advanced life support. 
C)  provide electrical cardioversion. 
D)  ignore the rhythm because it is benign.

Question 17

The nurse is talking with the patient when the monitor alarms and shows a wavy baseline without a PQRST complex.The nurse should:

Accepted Answer

A)  defibrillate the patient immediately. 
B)  initiate basic life support. 
C)  initiate advanced life support. 
D)  assess the patient and the electrical leads.

Question 18

Interpret the following rhythm:

Accepted Answer

A)  Sinus rhythm with multifocal premature ventricular contractions 
B)  Sinus rhythm with unifocal premature ventricular contractions 
C)  Sinus rhythm with bigeminal premature ventricular contractions 
D)  Sinus rhythm with paired premature ventricular contractions (couplets)

Question 19

One of the functions of the atrioventricular (AV)node is to:

Accepted Answer

A)  pace the heart if the ventricles fail. 
B)  slow the impulse arriving from the SA node. 
C)  send the impulse to the SA node. 
D)  allow for ventricular filling during systole.

Question 20

The nurse understands that in a third-degree AV block:

Accepted Answer

A)  every P wave is conducted to the ventricles. 
B)  some P waves are conducted to the ventricles. 
C)  none of the P waves are conducted to the ventricles. 
D)  the PR interval is prolonged.

Exam 7: Dysrhythmia Interpretation and Management

The patient's heart rhythm shows an inverted P wave with a PR interval of 0.06 seconds.The heart rate is 54 beats per minute.The nurse recognizes the rhythm as a junctional escape rhythm,and understands that the rhythm is due to the:

The patient is asymptomatic but is diagnosed with second-degree heart block Mobitz I.The patient is on digitalis medication at home.The nurse should expect that:

The patient has a permanent pacemaker inserted.The provider has set the pacemaker to the demand mode at a rate of 60 beats per minute.The nurse realizes that:

The patient is admitted with sinus pauses causing periods of loss of consciousness.The patient is asymptomatic,awake and alert,but fatigued.He answers questions appropriately.When admitting this patient,the nurse should first:

Interpret the following rhythm:

Electrocardiogram (ECG) paper contains a standardized grid where the horizontal axis measures time and the vertical axis measures voltage or amplitude.The nurse must understand that each horizontal box indicates:

Interpret the following rhythm:

Interpret the following rhythm:

The patient is in chronic junctional escape rhythm with no atrial activity noted.Studies have demonstrated normal AV node function.This patient may be a candidate for which type of pacing?

The patient has an irregular heart rhythm.To determine an accurate heart rate,the nurse first:

When assessing the 12-lead electrocardiogram (ECG) or a rhythm strip,it is helpful to understand that the electrical activity is viewed in relation to the positive electrode of that particular lead.When an electrical signal is aimed directly at the positive electrode,the inflection will be:

Interpret the following rhythm:

Interpret the following rhythm:

Interpret the following rhythm:

The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and there are no discernible P waves.The ventricular rate is 90 beats per minute,and the patient is hemodynamically stable.The nurse realizes that the patient's rhythm is:

The nurse notes the following rhythm on the heart monitor.The patient is unresponsive and not breathing.The nurse should

The nurse is talking with the patient when the monitor alarms and shows a wavy baseline without a PQRST complex.The nurse should:

Interpret the following rhythm:

One of the functions of the atrioventricular (AV) node is to:

The nurse understands that in a third-degree AV block: