Question 1

The nurse would explain to a client who has a demand pacemaker in place that this pacemaker functions by

Accepted Answer

A)  demanding the heart to contract at a preset rate. 
B)  firing after the SA node has started the cycle. 
C)  firing if the heart's electrical activity drops below a preset rate. 
D)  stimulating the SA node to fire.

Question 2

If the first defibrillation shock at 200 J is not successful on a client with ventricular fibrillation, the nurse in charge of the code would

Accepted Answer

A)  administer a second shock at 300 J. 
B)  reinitiate CPR. 
C)  reposition the client and shock at 200 J. 
D)  set the defibrillator to synchronous.

Question 3

A client is being discharge after having a pacemaker implantation. Self-care instructions the nurse should provide the client include (Select all that apply)

Accepted Answer

A)  carry a pacemaker identification card with you; wear a medical alert bracelet. 
B)  do not lift more than 5-10 pounds for the first 2 weeks after discharge. 
C)  take your pulse as directed and notify the doctor if it is less than the pacer rate. 
D)  you can safely operate most appliances, tools, and office equipment.

Question 4

A client's ECG reveals a rapid atrial rate of 300 beats/min, and the P waves resemble a picket fence without 1:1 conduction. The nurse would identify this dysrhythmia as

Accepted Answer

A)  atrial fibrillation. 
B)  atrial flutter. 
C)  paroxysmal atrial tachycardia. 
D)  sinoatrial block.

Question 5

A client is being discharged with a prescription for procainamide to treat atrial fibrillation. An important self-care measure the nurse would explain about this medication is to

Accepted Answer

A)  avoid milk products. 
B)  drink large amounts of citrus juice. 
C)  have blood pressure monitored frequently. 
D)  take the medication with meals.

Question 6

A client with no history of heart disease is seen in the clinic for periodic episodes of tachycardia with a regular rate. When taking the nursing history, the nurse would question the client about the existence of

Accepted Answer

A)  asthma. 
B)  diabetes. 
C)  stress. 
D)  weight gain.

Question 7

The nurse quickly calculating a client's heart rate by examining the electrocardiogram (ECG) would count the number of

Accepted Answer

A)  large squares between P waves and multiply by 10. 
B)  large squares between R waves and multiply by 10. 
C)  P waves in a 6-inch strip and multiply by 5. 
D)  R waves in a 6-inch strip and multiply by 10.

Question 8

To prevent possible complications from cardioversion, before administering the shock, the nurse would ensure that the (Select all that apply)

Accepted Answer

A)  emergency equipment is nearby and in working order. 
B)  joules are set to 50-100 joules initially on a monophasic machine. 
C)  machine is set to synchronize with the client's QRS complex. 
D)  the Code Blue team has arrived and is prepared.

Exam 57: Management of Clients with Dysrhythmias