Question 1

The nurse working on a telemetry floor would recognize that most dangerous dysrhythmias are

Accepted Answer

A)   atrial dysrhythmias.
B)   junctional dysrhythmias.
C)   nodal dysrhythmias.
D)   ventricular dysrhythmias. D

Question 2

A client is being discharged after unsuccessful cardioversion for atrial fibrillation. An important self-care measure the nurse should include in the discharge teaching plan is to tell the client to

Accepted Answer

A)   be sure to get plenty of rest balanced with activity.
B)   not eat too much red meat and other high-fat foods.
C)   reschedule the cardioversion in 2 weeks.
D)   take the Coumadin as scheduled. D

Question 3

A young athletic client has occasional episode of syncope. On further questioning, the nurse discovers the client has several relatives who had sudden cardiac death. The nurse should suggest the client be screened for

Accepted Answer

A)   atrial dysrhythmias.
B)   familial sudden cardiac death syndrome.
C)   long QT syndrome.
D)   ventricular dysrhythmias. C

Question 4

A client in the CCU goes into sudden ventricular fibrillation. The priority action by the nurse would be to immediately administer

Accepted Answer

A)   a lidocaine bolus.
B)   atropine.
C)   cardiopulmonary resuscitation (CPR) .
D)   intravenous (IV)  magnesium.

Question 5

At the ambulatory care clinic, the nurse counseling a client who has presented with frequent episodes of paroxysmal atrial tachycardia would advise the client to

Accepted Answer

A)   avoid all aspirin and nonsteroidal anti-inflammatory drugs.
B)   eat a low-salt, low-fat diet that contains plenty of fiber.
C)   get 30 minutes of exercise and drink six glasses of water per day.
D)   quit smoking and avoid caffeine and alcohol.

Question 6

When a client develops sinus bradycardia after a myocardial infarction (MI), the nurse would anticipate the administration of

Accepted Answer

A)   atropine.
B)   digitalis.
C)   procainamide.
D)   propranolol.

Question 7

If a client admitted to the hospital for treatment of atrial fibrillation complains of dyspnea and chest pain, the nurse would suspect

Accepted Answer

A)   heart block.
B)   myocardial infarction.
C)   pulmonary edema.
D)   pulmonary emboli.

Question 8

The nurse would be most concerned about premature ventricular contractions (PVCs) that

Accepted Answer

A)   are uniform in appearance.
B)   fall on a T wave.
C)   occur at a rate of four per minute.
D)   occur with angina.

Question 9

When a client in the CCU develops ventricular tachycardia and loses consciousness, the priority action by the nurse would be to immediately administer

Accepted Answer

A)   defibrillation.
B)   lidocaine.
C)   quinidine.
D)   verapamil.

Question 10

The nurse would assess a heart rate of 55 beats/min as a normal finding in a client who

Accepted Answer

A)   is an athlete.
B)   is obese.
C)   takes a diuretic.
D)   weighs less than 90 pounds.

Question 11

For a client being prepared to receive an automatic implantable cardioverter-defibrillator (AICD) after surviving two episodes of ventricular fibrillation, the nurse would address the client's

Accepted Answer

A)   acute pain.
B)   anxiety.
C)   fatigue.
D)   decreased cardiac output.

Question 12

Before the insertion of a temporary pacemaker, the nurse should assess the client's (Select all that apply)

Accepted Answer

A)   anxiety level.
B)   coping mechanisms.
C)   knowledge level.
D)   past experience with temporary pacers.

Question 13

Before a client receives cardioversion, the nurse should ensure that the client

Accepted Answer

A)   ate only a light breakfast.
B)   has signed a consent form.
C)   is not wearing jewelry.
D)   skipped today's digoxin dose.

Question 14

When the normal pacemaker is impaired and latent pacemaker cells in the AV node initiate the cardiac cycle, the nurse would clarify that this pacemaker is called the

Accepted Answer

A)   altered pacemaker.
B)   delayed pacemaker.
C)   escape pacemaker.
D)   junctional pacemaker.

Question 15

The client who is to receive cardioversion in 3 days for treatment of continuous atrial fibrillation has laboratory values of Na 139 mEq/L, K 4.0 mEq/L, and Cl 98 mEq/L and is receiving digoxin 0.125 mg daily. Before the procedure the nurse would

Accepted Answer

A)   confirm an order for a digoxin level before cardioversion.
B)   monitor blood pressure more frequently.
C)   notify the physician regarding the potassium level.
D)   proceed with preparation for cardioversion.

Question 16

A client with a serum potassium level of 6.6 mEq/L would have a characteristic ECG configuration of

Accepted Answer

A)   increased PR interval.
B)   inverted QRS complex.
C)   no change.
D)   tall T wave.

Question 17

When a client in the cardiac care unit (CCU) suddenly develops paroxysmal atrial tachycardia (PAT) of 200 beats/min and clinical manifestations of severe dizziness, the nurse would help decrease the heart rate by

Accepted Answer

A)   administering digitalis intravenously.
B)   asking the client to perform the Valsalva maneuver.
C)   increasing the client's oxygen.
D)   lowering the head of the bed.

Question 18

When the nurse in charge of the code is ready to defibrillate a client, the nurse assisting with the defibrillation would

Accepted Answer

A)   assess for unresponsiveness.
B)   continue to perform CPR.
C)   prepare to administer lidocaine.
D)   stand away from the bed.

Question 19

The client's ECG shows normal-appearing P waves that occur at regular intervals. Every third impulse from the atria is missing a QRS complex. The nurse would recognize this pattern as the dysrhythmia of

Accepted Answer

A)   first-degree AV block.
B)   second-degree AV block.
C)   third-degree AV block.
D)   fourth-degree AV block.

Question 20

The nurse would clarify to a client that sinus arrest differs from sinus block in that with sinus arrest, the

Accepted Answer

A)   atrial focus totally takes over pacing responsibility.
B)   atrioventricular (AV)  node is the primary pacemaker.
C)   rhythm is regular.
D)   sinoatrial (S
A)   node occasionally fails to fire.

Exam 57: Management of Clients with Dysrhythmias