Test 3 chapter 26
A nurse is teaching the client about the causes of fast heart rates. What client statement indicates the client requires more teaching? "I will drink coffee with only two of my meals." "I will cut back on my smoking and drinking alcohol." "If I take my metoprolol daily, I will be able to control my heart rate." "I will take my levothyroxine daily."
"I will drink coffee with only two of my meals."
A client scheduled for a catheter ablation procedure confides to the nurse that he is worried about having some of his heart cells destroyed. The best response by the nurse is which of the following? "Only the specific cells causing your dysrhythmia are destroyed; your heart will function better without these cells." "The doctor knows best; just let her worry about which heart cells to destroy." "Everything will turn out fine; do not worry about your heart cells." "Don't worry. All resuscitation equipment is kept nearby when these procedures are being done."
"Only the specific cells causing your dysrhythmia are destroyed; your heart will function better without these cells."
The nurse receives a telephone call from a client with an implanted pacemaker who reports a pulse of 68 beats per minute, but the pacemaker rate is set at 72 beats per minute. What is the nurse's best response? "Please come to the clinic right away so that we may interrogate the pacemaker to see if it is malfunctioning." "Don't worry. The pacemaker's rate is often higher than the client's actual heart rate." "This is okay as long as you are not having any symptoms." "Try walking briskly for about 5 minutes to see if that gets your heart rate to increase."
"Please come to the clinic right away so that we may interrogate the pacemaker to see if it is malfunctioning."
The nursing student learning on a cardiac unit asks the instructor why loss of the "atrial kick" causes a decrease in cardiac output, because the ventricles are still contracting. What is the nursing instructor's best response? "The atrial contraction fills the ventricles and accounts for nearly one-third of the volume ejected during ventricular contraction." "Loss of the atrial kick does not affect cardiac output; cardiac output remains the same, with or without it." "The atrial kick is only helpful if the ventricles are failing." "The atrial kick is never lost; there is always some atrial kick present."
"The atrial contraction fills the ventricles and accounts for nearly one-third of the volume ejected during ventricular contraction."
During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response? "Cardioversion is done on a beating heart; defibrillation is not." "The difference is the timing of the delivery of the electric current." "Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not." "Cardioversion is always attempted before defibrillation because it has fewer risks."
"The difference is the timing of the delivery of the electric current."
The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply? "The only difference is the heart rate." "The P waves will be shaped differently." "The QRS complex will be smaller in sinus bradycardia." "The P-R interval will be prolonged in sinus bradycardia."
"The only difference is the heart rate."
A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next? Begin cardiopulmonary resuscitation Prepare for endotracheal intubation Provide electrical cardioversion Administer intravenous epinephrine
Begin cardiopulmonary resuscitation
Which medication is the drug of choice for sinus bradycardia? Atropine Lidocaine Pronestyl Cardizem
Atropine
The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action? defibrillation cardioversion IV bolus of atropine IV bolus of dobutamine
defibrillation
A client is admitted to the emergency department reporting chest pain and shortness of breath. The nurse notes an irregular rhythm on the bedside electrocardiograph monitor. The nurse counts 9 RR intervals on the client's 6-second rhythm tracing. The nurse correctly identifies the client's heart rate as 90 bpm. 80 bpm. 70 bpm. 100 bpm.
90 bpm.
A client is scheduled for an elective electrical cardioversion for a sustained dysrhythmia lasting for 24 hours. Which intervention is necessary for the nurse to implement prior to the procedure? Administer moderate sedation IV and analgesic medication as prescribed. Administer the prescribed digitalis to the client before the scheduled procedure. Administer anticoagulant therapy as prescribed prior to the procedure. Maintain the client on NPO status for 8 hours prior to the procedure.
Administer moderate sedation IV and analgesic medication as prescribed.
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client? Assessing the client's blood pressure and heart rate frequently Identifying the client's code level status Maintaining the client's intravenous fluids Alerting the healthcare provider of the third-degree heart block
Alerting the healthcare provider of the third-degree heart block
A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What other conditions can cause this response in a healthy heart? All options are correct. elevated temperature shock strenuous exercise
All options are correct.
What is the drug of choice for a stable client with ventricular tachycardia? Atropine Amiodarone Procainamide Lidocaine
Amiodarone
The nurse is in the mall and observes a client slump to the floor. The nurse assesses the client and notes no pulse. The nurse calls for assistance to others in the mall and requests which piece of equipment? A blood pressure cuff A cell phone to call 911 An automatic external defibrillator A stethoscope
An automatic external defibrillator
A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client 's monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse's first response? Assess the client and monitor leads. Administer a pericardial thump. Call for assistance and begin CPR. Call a code and obtain the crash cart.
Assess the client and monitor leads.
The registered nurse reviewed the patient's vital signs and noted a consistent pattern of heart rate recordings between 48 and 58 bpm over a 24-hour period of time. What medication will cause bradycardia? Aminophylline Atropine Atenolol Epinephrine
Atenolol
A patient with mitral valve stenosis and coronary artery disease (CAD) is in the telemetry unit with pneumonia. The nurse assesses a 6-second rhythm strip and determines that the ventricular rhythm is highly irregular at a rate of 150 bpm, with no discernible P waves. What does the nurse determine this rhythm to be? Atrial fibrillation Ventricular fibrillation Sinus tachycardia Nonparoxysmal junctional tachycardia
Atrial fibrillation
A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder? Asystole Premature ventricular contraction Atrial flutter Ventricular fibrillation
Atrial flutter
A client's electrocardiogram (ECG) tracing reveals a atrial rate between 250 and 400, with saw-toothed P waves. The nurse correctly identifies this dysrhythmia as Atrial flutter Atrial fibrillation Ventricular fibrillation Ventricular tachycardia
Atrial flutter
A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic? Scar on the chest "Spike" on the rhythm strip Quality of the pulse Vibration under the skin
"Spike" on the rhythm strip
The nurse is speaking with a client admitted with a dysrhythmia. The client asks the nurse to explain the "F waves" on the electrocardiogram. What is the nurse's best response? "The F waves are flutter waves representing atrial activity." "The F waves are flutter waves representing ventricular activity." "The F waves are normal parts of the heart conduction system" "The F waves are most likely caused by the new medication."
"The F waves are flutter waves representing atrial activity."
After evaluating a client for hypertension, a health care provider orders atenolol, 50 mg P.O. daily. Which therapeutic effect should atenolol have in treating hypertension? Decreased cardiac output and decreased systolic and diastolic blood pressure Decreased blood pressure with reflex tachycardia Increased cardiac output and increased systolic and diastolic blood pressure Decreased peripheral vascular resistance
Decreased cardiac output and decreased systolic and diastolic blood pressure
A client is scheduled for catheter ablation therapy. When describing this procedure to the client's family, the nurse should address which aspect of the treatment? Resetting of the heart's contractility Destruction of specific cardiac cells Correction of structural cardiac abnormalities Clearance of partially occluded coronary arteries
Destruction of specific cardiac cells
Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion? Atropine Digoxin Enalapril Diazepam
Diazepam
The ED nurse is caring for a client who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform? Place gel pads over the apex and posterior chest for better conduction. Ensure no one is touching the client at the time shock is delivered. Continue to ventilate the client via endotracheal tube during the procedure. Allow at least 3 minutes between shocks.
Ensure no one is touching the client at the time shock is delivered.
The nurse receives a client from the postanesthesia unit with a new onset of sinus tachycardia and a heart rate of 118 beats per minute. To which reasons does the nurse relate the increased heart rate? Select all that apply. Fever Blood loss Sleep Hypoglycemia Anxiety
Fever Blood loss Anxiety
An adult client with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show? PP interval and RR interval are irregular. PP interval is equal to RR interval. Fewer QRS complexes than P waves PR interval is constant.
Fewer QRS complexes than P waves
An ECG has been ordered for a newly admitted client. What should the nurse do prior to electrode placement? Clean the skin with povidone-iodine solution. Ensure that the area for electrode placement is dry. Apply tincture of benzoin to the electrode sites and wait for it to become "tacky." Gently abrade the skin by rubbing the electrode sites with dry gauze or cloth.
Gently abrade the skin by rubbing the electrode sites with dry gauze or cloth.
When planning the care of a client with an implanted pacemaker, what assessment should the nurse prioritize? Core body temperature Heart rate and rhythm Blood pressure Oxygen saturation level
Heart rate and rhythm
The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia? PR interval of 0.24 seconds. Heart rate of 42 beats per minute (bpm). QR interval of 0.25 seconds. P-to-QR ratio of 1:2.
Heart rate of 42 beats per minute (bpm).
A 43-year-old male came into the emergency department where you practice nursing and was diagnosed with atrial fibrillation. It's now 48 hours since his admittance and the dysrhythmia persists. Which of the following medications will the client's healthcare provider most likely order? Heparin Warfarin (Coumadin) Flecainide (Tambocor) Dabigatran (Pradaxa)
Heparin
The nurse understands that asystole can be caused by several conditions. Select all that apply. Hypoxia Alkalosis Hypovolemia Hypothermia Acidosis
Hypoxia Hypovolemia Hypothermia Acidosis
The staff educator is teaching a class in dysrhythmias. What statement is correct for defibrillation? It is a scheduled procedure 1 to 10 days in advance. The client is sedated before the procedure. It is used to eliminate ventricular dysrhythmias. It uses less electrical energy than cardioversion.
It is used to eliminate ventricular dysrhythmias.
The nurse is caring for a client who has a suspected dysrhythmia. What most appropriate intervention should the nurse use to help detect dysrhythmias? Monitor blood pressure continuously. Monitor cardiac rhythm continuously. Provide supplemental oxygen. Palpate the client's pulse and observe the client's response.
Monitor cardiac rhythm continuously.
The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? Date and time of insertion Location of the generator Model number Pacer rate
Pacer rate
Which ECG waveform characterizes conduction of an electrical impulse through the left ventricle? P wave QRS complex PR interval QT interval
QRS complex
A 28-year-old client presents to the emergency department, stating severe restlessness and anxiety. Upon assessment, the client's heart rate is 118 bpm and regular, the client's pupils are dilated, and the client appears excitable. Which action should the nurse take next? Question the client about alcohol and illicit drug use. Instruct the client to hold the breath and bear down. Prepare to administer a calcium channel blocker. Place the client on supplemental oxygen.
Question the client about alcohol and illicit drug use.
A client has undergone diagnostic testing and received a diagnosis of sinus bradycardia attributable to sinus node dysfunction. When planning this client's care, what nursing diagnosis is most appropriate? Acute pain Risk for unilateral neglect Risk for activity intolerance Risk for fluid volume excess
Risk for activity intolerance
The staff educator is presenting a class on cardiac dysrhythmias. How would the educator describe the characteristic pattern of the atrial waves in atrial flutter? Sinusoidal Triangular Sawtooth Square
Sawtooth
The nurse is preparing to defibrillate a client with no breathing or pulse. Which nursing action precedes the nurse's pressing the discharge button? Placing gel on the chest Checking the ECG rhythm Shouting "Clear!" Stating "Charging."
Shouting "Clear!"
Which dysrhythmia is common in older clients? Sinus bradycardia Sinus tachycardia Sinus arrhythmia Ventricular tachycardia
Sinus bradycardia
The nurse is preparing to administer adenosine for a patient diagnosed with atrial flutter. How should the nurse administer this medication? The dose is administered rapid IV push. The dose is administered slow IV push. The medication is followed by a slow saline flush. The medication is followed by a rapid lactated Ringer's (LR) flush
The dose is administered rapid IV push.
The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated? The registered nurse stating to administer digoxin The registered nurse administering atropine sulfate intravenously The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute The registered nurse stating to administer all medications except those which are cardiotonics
The registered nurse administering atropine sulfate intravenously
When no atrial impulse is conducted through the AV node into the ventricles, the client is said to be experiencing which type of AV block? First degree Second degree, type I Second degree, type II Third degree
Third degree
A client asks the nurse about complications associated with use of a cardiac pacemaker. What does the nurse include in their response? Select all that apply. Twiddler syndrome Hiccupping Positive Kernig's sign Localized infection Negative Babinski reflex
Twiddler syndrome Hiccupping Localized infection
A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi? Adenosine Amiodarone Warfarin Atropine
Warfarin
The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity? "You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks." "You may resume all normal activity in 1 week; if you are used to playing tennis, you may proceed with this activity." "You should avoid tennis; basketball or football would be a good substitute." "Cancel your tennis tournament and wait until fall, then try hockey; skating is much easier on pacemakers."
You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client? assessing blood pressure and heart rate frequently identifying a code-level status maintaining intravenous fluids alerting the healthcare provider of the third-degree heart block
alerting the healthcare provider of the third-degree heart block
A client has an irregular heart rate of around 100 beats/minute and a significant pulse deficit. What component of the client's history would produce such symptoms? atrial fibrillation atrial flutter heart block bundle branch block
atrial fibrillation
The nurse is assessing a client with symptomatic bradycardia. What medication does the nurse anticipate will be ordered by the healthcare provider to treat the bradycardia? atropine lidocaine diltiazem adenosine
atropine
The nurse is admitting a client to a telemetry unit with an atrial dysrhythmia. What symptoms will the nurse further evaluate? chest pain hypertension leg pain hypocarbia
chest pain
A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client's problems. Which test is used to identify cardiac rhythms? electrocardiogram electroencephalogram echocardiogram electrocautery
electrocardiogram
A client with a history of mitral stenosis is admitted to the intensive care unit (ICU) with the abrupt onset of atrial fibrillation. The client's heart rate ranges from 120 to 140 bpm. The nurse recognizes that interventions are implemented to prevent the development of embolic stroke. myocardial infarction. heart failure. renal failure.
embolic stroke.
The nurse is administering propranolol to a client on a telemetry unit. What will the nurse monitor the client for? heart block tachycardia bleeding change in level of consciousness
heart block
The health care provider prescribes esmolol for a client with supraventricular tachycardia. During esmolol therapy, what should the nurse monitor? body temperature. heart rate and blood pressure. ocular pressure. cerebral perfusion pressure.
heart rate and blood pressure.
A client experiences a faster-than-normal heart rate when drinking more than two cups of coffee in the morning. What does the nurse identify on the electrocardiogram as an indicator of sinus tachycardia? heart rate of 118 bpm PR interval of 0.1 seconds QRS duration of 0.16 seconds Q wave of 0.04 seconds
heart rate of 118 bpm
The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia? hypovolemia vagal stimulation hypothyroidism digoxin
hypovolemia
A client with dilated cardiomyopathy is having frequent episodes of ventricular fibrillation. What medical treatment does the nurse anticipate the client will have to terminate the episode of ventricular fibrillation? internal cardioverter defibrillator insertion pacemaker insertion radiofrequency ablation electrophysiological study
internal cardioverter defibrillator insertion
The client returns to the clinic for a follow-up appointment following a permanent pacemaker insertion and reports tenderness and throbbing around the incision. The nurse observes mild swelling, erythema, and warmth at the pacemaker insertion site. What does the nurse suspect? pacemaker site infection normal postoperative healing postoperative site hematoma internal bleeding at pacemaker site
pacemaker site infection
A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute with a regular interval between 0.12 and 0.20 seconds. What type of dysrhythmia does the client have? sinus bradycardia atrial bradycardia heart block none
sinus bradycardia
The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm shown. Which dysrythmia should the nurse document? ventricular tachycardia ventricular asystole sinus rhythm junctional rhythm atrial fibrillation
ventricular tachycardia
The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. Which question by the client indicates a need for clarification? "I should ask for a handheld device search when I go through airport security." "I should avoid large magnetic fields, such as an MRI machine or large motors." "I should avoid contact sports." "I'll watch the incision for swelling or redness and will report if either occurs."
"I should ask for a handheld device search when I go through airport security."
A nurse is caring for a client with atrial fibrillation. What procedure would the nurse educate the patient about for termination of the dysrhythmia? Defibrillation Mace procedure Pacemaker implantation Elective cardioversion
Elective cardioversion
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia? Defibrillation Maze procedure Pacemaker implantation Elective cardioversion
Elective cardioversion
A cardiac care nurse is caring for a client who is experiencing positive chronotropy. What effect should the nurse prepare for? Exacerbation of an existing dysrhythmia Initiation of a new dysrhythmia Resolution of ventricular tachycardia Increased heart rate
Increased heart rate
A patient has a persistent third-degree heart block and has had several periods of syncope. What priority treatment should the nurse anticipate for this patient? Insertion of a pacemaker Administration of atropine Administration of epinephrine Insertion of an implantable cardioverter defibrillator (ICD)
Insertion of a pacemaker
The nurse is attempting to determine the ventricular rate and rhythm of a patient's telemetry strip. What should the nurse examine to determine this part of the analysis? PP interval QT interval RR interval TP interval
RR interval
The nurse is providing discharge teaching with a client about pacemaker surveillance. Which client statement indicates a need for further teaching? c "If possible, I would like to use the transtelephonic method for a follow-up." "The surveillance frequency of the follow-up varies with each person." "The surveillance checks will determine how much battery life is available."
"I will take acetaminophen prior to the appointment to lessen the interrogation pain."
The nurse is caring for a 32-year-old client admitted with a medical diagnosis of atrial fibrillation, related to "holiday heart" syndrome. A nursing student working with the nurse asks for information about "holiday heart" syndrome. Which is the best response by the nurse? "This is the association of heart dysrhythmias, especially atrial fibrillation, with binge drinking." "This is the association of heart dysrhythmias, especially atrial fibrillation, with extramarital sex." "This is the association of heart dysrhythmias, especially atrial fibrillation, with physical activity the client is not used to." "This is the association of heart dysrhythmias, especially atrial fibrillation, with very heavy meals."
"This is the association of heart dysrhythmias, especially atrial fibrillation, with binge drinking."
The nurse is caring for a client scheduled for a transesophageal echocardiogram with a diagnosis of atrial fibrillation. The client's spouse asks the nurse to explain the purpose of the test. What is the nurse's best response? "This test will show any blood clots in the heart, and help us determine if it is safe to do a cardioversion." "This test will show the specific area causing the atrial fibrillation and what can be done to stop it." "This test will show if the client needs a cardiac catheterization." "This test will let the doctor know if the client is at risk for hypotension."
"This test will show any blood clots in the heart, and help us determine if it is safe to do a cardioversion."
The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response? "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes." "The two look very much alike; it is difficult to tell the difference." "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width." "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal."
"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."
A monitor technician on the telemetry unit asks a charge nurse why every client whose monitor shows atrial fibrillation is receiving warfarin. Which response by the charge nurse is best? "It's just a coincidence; most clients with atrial fibrillation don't receive warfarin." "Warfarin controls heart rate in the client with atrial fibrillation." "Warfarin prevents atrial fibrillation from progressing to a lethal arrhythmia." "Warfarin prevents clot formation in the atria of clients with atrial fibrillation."
"Warfarin prevents clot formation in the atria of clients with atrial fibrillation."
The nurse is caring for a client who had a permanent pacemaker surgically placed and is now ready for discharge. What statement made by the client indicates the need for more education? "We will be getting rid of our microwave oven so it will not affect my pacemaker." "I will check my pulse every day and report to the doctor if the rate is below the pacemaker setting." "I will call the doctor if my incision becomes swollen and red." "I will avoid any large magnets that may affect my pacemaker."
"We will be getting rid of our microwave oven so it will not affect my pacemaker."
The nurse is working with a client with a new onset of atrial fibrillation during a three-month follow-up visit. The healthcare provider is planning a cardioversion, and the client asks the nurse why there is a wait for the treatment. What is the best response by the nurse? "The doctor wants to see if your heart will switch back to its normal rhythm by itself." "Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion." "We have to allow your heart to rest for a few weeks before it is stressed by the cardioversion." "There is a long list of clients in line to be cardioverted."
"Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion."
The licensed practical nurse is setting up the room for a client arriving at the emergency department with ventricular arrhythmias. The nurse is most correct to place which of the following in the room for treatment? A suction machine A defibrillator Cardioversion equipment An ECG machine
A defibrillator
The nurse is assigned to care for several clients admitted to a telemetry unit. Which clients should the nurse assess first? A client whose implantable cardioverter defibrillator (ICD) fired twice on the prior shift, requiring amiodarone IV A client who received elective cardioversion 1 hour ago and whose heart rate (HR) is 115 bpm A client diagnosed with new onset of atrial fibrillation, requiring scheduled IV diltiazem A client returned from an electrophysiology procedure 2 hours ago, reporting constipation
A client whose implantable cardioverter defibrillator (ICD) fired twice on the prior shift, requiring amiodarone IV
The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment? A new myocardial infarction client A client with poor kidney perfusion A client with third-degree heart block A client with atrial dysrhythmias
A client with atrial dysrhythmias
A client is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this client is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine? Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg. Administer atropine as a continuous infusion until symptoms resolve. Administer atropine as a continuous infusion to a maximum of 30 mg in 24 hours. Administer atropine 1.0 mg sublingually.
Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg.
Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation? Diuretic Anticoagulant Antihypertensive Potassium supplement
Anticoagulant
The nurse is monitoring a patient in the postanesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm? Atrial fibrillation Atrial flutter Ventricular tachycardia Ventricular fibrillation
Atrial flutter
Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves? Atrial flutter Atrial fibrillation Ventricular fibrillation Ventricular tachycardia
Atrial flutter
The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what? Atrial rate of 300 to 400 Normal PR interval Regular rhythm P wave resent before each QRS
Atrial rate of 300 to 400
A nurse completes a shift assessment on a client admitted to the telemetry unit with a diagnosis of syncope. The client's heart rate is 55 bpm with a blood pressure of 90/66 mm Hg. The client is also experiencing dizziness and shortness of breath. Which medication will the nurse anticipate administering to the client based on these clinical findings? Atropine Lidocaine Pronestyl Cardizem
Atropine
A nurse is caring for a client who's experiencing sinus bradycardia with a pulse rate of 40 beats/minute. The client's blood pressure is 80/50 mm Hg and the client reports dizziness. Which medication does the nurse anticipate administering to treat bradycardia? Atropine Dobutamine Amiodarone Lidocaine
Atropine
The nurse is planning discharge teaching for a client with a newly inserted permanent pacemaker. What is the priority teaching point for this client? Start lifting the arm above the shoulder right away to prevent chest wall adhesion. Avoid cooking with a microwave oven. Avoid exposure to strong electromagnetic fields Avoid walking through store and library antitheft devices.
Avoid exposure to strong electromagnetic fields
The nurse cares for a client following the insertion of a permanent pacemaker. What discharge instruction(s) should the nurse review with the client? Select all that apply. Avoid handheld screening devices in airports Refrain from walking through antitheft devices Check pulse daily, reporting sudden slowing or increase Avoid the usage of microwave ovens and electronic tools Wear a medical alert, noting the presence of a pacemaker
Avoid handheld screening devices in airports Check pulse daily, reporting sudden slowing or increase Wear a medical alert, noting the presence of a pacemaker
Which postimplantation instruction must a nurse provide to a client with a permanent pacemaker? Keep the arm on the side of the pacemaker higher than the head Delay activities such as swimming and bowling for at least 3 weeks Keep moving the arm on the side where the pacemaker is inserted Avoid sources of electrical interference
Avoid sources of electrical interference
A client has had a pacemaker implanted and the nurse will begin client education upon the client becoming alert. Which postimplantation instructions must be provided to the client with a permanent pacemaker? Avoid sources of electrical interference. Keep the arm on the side of the pacemaker higher than the head. Delay activities such as swimming and bowling for at least 3 weeks. Keep moving the arm on the side where the pacemaker is inserted.
Avoid sources of electrical interference.
The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client? Stay at least 5 feet away from microwave ovens. Never engage in activities that require vigorous arm and shoulder movement. Avoid going through airport metal detectors. Avoid undergoing magnetic resonance imaging (MRI).
Avoid undergoing magnetic resonance imaging (MRI).
The nurse in the intensive care unit (ICU) hears an alarm sound in the patient's room. Arriving in the room, the patient is unresponsive, without a pulse, and a flat line on the monitor. What is the first action by the nurse? Begin cardiopulmonary resuscitation (CPR) Administer epinephrine Administer atropine 0.5 mg Defibrillate with 360 joules (monophasic defibrillator)
Begin cardiopulmonary resuscitation (CPR)
A client has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this client? Chest pain Bleeding at the implantation site Malignant hyperthermia Bradycardia
Bleeding at the implantation site
A nurse is caring for a client who is exhibiting ventricular tachycardia (VT). Because the client is pulseless, the nurse should prepare for what intervention? Defibrillation ECG monitoring Implantation of a cardioverter defibrillator Angioplasty
Defibrillation
A client has been living with an internal, fixed-rate pacemaker. When checking the client's readings on a cardiac monitor the nurse notices an absence of spikes. What should the nurse do? Double-check the monitoring equipment. Do nothing; there is no cause for alarm. Suggest the need for a new beta-blocker to the doctor. Measure the client's blood pressure.
Double-check the monitoring equipment.
A nurse is caring for a client with a history of cardiac disease and type 2 diabetes. The nurse is closely monitoring the client's blood glucose level. Which medication is the client most likely taking? Procainamide Carvedilol Amiodarone Diltiazem
Carvedilol
The nurse is caring for a client who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output? Increased blood pressure Bounding peripheral pulses Changes in level of consciousness Skin flushing
Changes in level of consciousness
The nurse knows that a pacemaker is the treatment of choice for what cardiac dysrhythmia? Supraventricular tachycardia Atrial flutter Ventricular fibrillation Complete heart block
Complete heart block
A client converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV heparin and diltiazem are given. The nurse caring for the client understands that the main goal of treatment is what? Decrease SA node conduction Control ventricular heart rate Improve oxygenation Maintain anticoagulation
Control ventricular heart rate
The nurse and the other members of the team are caring for a client who converted to ventricular fibrillation (VF). The client was defibrillated unsuccessfully and the client remains in VF. The nurse should anticipate the administration of what medication? Epinephrine 1 mg IV push Lidocaine 100 mg IV push Amiodarone 300 mg IV push Sodium bicarbonate 1 amp IV push
Epinephrine 1 mg IV push
The nurse assesses a client returning from the post anesthesia unit with a new onset of sinus tachycardia with a heart rate of 138 beats per minute and a blood pressure of 128/80mmHg after elevating the head of the bed. What intervention does the nurse consider? Assessing blood glucose level Decreasing intravenous fluids Removing anti-embolism stockings Evaluating laboratory values
Evaluating laboratory values
A nurse enters a client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client? IV lidocaine Chemical cardioversion Immediate CPR Electric cardioversion
Immediate CPR
hat is the treatment of choice for ventricular fibrillation? Immediate bystander CPR Pacemaker Implanted defibrillator Atropine
Immediate bystander CPR
The nurse is caring for a client who has just been diagnosed with sinus bradycardia. The client asks the nurse to explain what sinus bradycardia is. What would be the nurse's best explanation? In many clients a heart rate slower than 60 beats per minute is considered to slow to maintain an adequate cardiac output. Sinus bradycardia means your heart is not beating fast enough to keep you alive. Sinus bradycardia is nothing to worry about. In many clients a heart rate slower than 70 beats per minute is considered to slow to maintain an adequate cardiac output.
In many clients a heart rate slower than 60 beats per minute is considered to slow to maintain an adequate cardiac output.
Which nursing intervention is required to prepare a client with cardiac dysrhythmia for an elective electrical cardioversion? Instruct the client to restrict food and oral intake Administer digitalis and diuretics 24 hours before cardioversion Facilitate CPR until the client is prepared for cardioversion Monitor blood pressure every 4 hours
Instruct the client to restrict food and oral intake
A patient is 2 days postoperative after having a permanent pacemaker inserted. The nurse observes that the patient is having continuous hiccups as the patient states, "I thought this was normal." What does the nurse understand is occurring with this patient? Fracture of the lead wire Lead wire dislodgement Faulty generator Sensitivity is too low
Lead wire dislodgement
A nurse should obtain serum levels of which electrolytes in a client with frequent episodes of ventricular tachycardia? Calcium and magnesium Potassium and calcium Magnesium and potassium Potassium and sodium
Magnesium and potassium
The nurse is writing a plan of care for a client with a cardiac dysrhythmia. What would be the priority goal for the client? Maintain a resting heart rate below 70 bpm. Maintain adequate control of chest pain. Maintain adequate cardiac output. Maintain normal cardiac structure.
Maintain adequate cardiac output.
The nurse is caring for an adult client who has gone into ventricular fibrillation. When assisting with defibrillating the client, what must the nurse do? Maintain firm contact between paddles and the client's skin. Apply a layer of water as a conducting agent. Call "all clear" once before discharging the defibrillator. Ensure the defibrillator is in the sync mode.
Maintain firm contact between paddles and the client's skin.
Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia? Keep the client flat for one hour after administration Administer every five minutes during cardiac resuscitation Document heart rate before and after administration Monitor vital signs and cardiac rhythm
Monitor vital signs and cardiac rhythm
The nurse expects to see which of the following characteristics on an ECG strip for a patient who has third-degree AV block? Extended PR interval More P waves than QRS complexes Atrial rate of 60 bpm or below Shortened QRS duration.
More P waves than QRS complexes
A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing? Sinus bradycardia Ventricular tachycardia Normal sinus rhythm Sinus tachycardia
Sinus tachycardia
A client has been diagnosed with atrial fibrillation and has been prescribed warfarin therapy. What should the nurse prioritize when providing health education to the client? The need to have regular blood levels drawn The importance of taking the medication 1 hour before or 2 hours after a meal The need to sit upright for 30 minutes after taking the medication The importance of adequate fluid intake
The need to have regular blood levels drawn
The nurse knows which heart rhythm occurs when the atrial and ventricular rhythms are both regular, but independent of each other? Third-degree atrioventricular (AV) heart block Second-degree heart block First-degree AV block Asystole
Third-degree atrioventricular (AV) heart block
The nurse caring for a client whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this client? Implanted pacemaker Transcutaneous pacemaker ICD Asynchronous defibrillator
Transcutaneous pacemaker
A patient who had a myocardial infarction is experiencing severe chest pain and alerts the nurse. The nurse begins the assessment but suddenly the patient becomes unresponsive, no pulse, with the monitor showing a rapid, disorganized ventricular rhythm. What does the nurse interpret this rhythm to be? Ventricular tachycardia Atrial fibrillation Third-degree heart block Ventricular fibrillation
Ventricular fibrillation
The nurse is caring for a client who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurse's assessment? Assessing the client's mobility Facilitating transthoracic echocardiography Vigilant monitoring of the client's ECG Close monitoring of the client's peripheral perfusion
Vigilant monitoring of the client's ECG
The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include? Your family and friends may want to take a CPR class. It is not necessary to learn how to take your own pulse. If you miss a dose of your antiarrhythmic medication, double up on the next dose. Do not be concerned if you experience symptoms of lightheadedness and dizziness.
Your family and friends may want to take a CPR class.
A client's electrocardiogram reveals an irregular rhythm of 75 bpm with a normal QRS and P wave. The nurse who is caring for the client should anticipate: administration of epinephrine. a bolus of warmed normal saline. administration of a beta-adrenergic blocker. no immediate treatment.
no immediate treatment.