EKG
which assessment finding would the nurse identify as an adverse effect of a client's lidocaine infusion? 1. tremors 2. tachypnea 3. tachycardia 4. hypertension
1
which nursing intervention is important when caring for clients receiving intravenous (IV) digoxin? (select all that apply) 1. monitor the heart rate closely 2. check the blood levels of digoxin 3. administer the dose over 1 minute 4. monitor the serum potassium level 5. give the medication with other infusion medications
1, 2, 4
which is the priority nursing intervention immediately after a client has a ventricular demand pacemaker inserted? 1. encourage fluids 2. assess the implant site 3. monitor the heart rate and rhythm 4. encourage turning and deep breathing
3
a client with paroxysmal supra ventricular tachycardia reports a mild "fluttering feeling" in their chest and has a blood pressure of 110/55 mm Hg. which potential treatment by the HCP would the nurse question? 1. intravenous adenosine 2. intravenous metoprolol 3. carotid sinus massage 4. synchronized cardioversion
4
a client with paroxysmal supra ventricular tachycardia reports a mild "fluttering feeling" in their chest and has a blood pressure of 110/55 mm Hg. which potential treatment by the health care provider would the nurse question? 1. intravenous adenosine 2. intravenous metoprolol 3. carotid sinus massage 4. synchronized cardioversion
4
a patient with a history of chronic obstructive pulmonary disease (COPD) develops sinus tachycardia. the nurse recognizes that this may be due to: 1. hypovolemia 2. sympathetic stimulation 3. parasympathetic stimulaiton 4. impaired oxygen
4
which response would the nurse provide to a client receiving digoxin who calls the clinic and complains of "yellow vision"? 1. "this is related to your illness rather than to your medication" 2. "this is an expected side effect; you will become accustomed to it over time" 3. "this side effect is only temporary. you should continue the medication" 4. "the medication may need to be discontinued. come to the clinic this afternoon"
4
which rhythm is the client experiencing when the cardiac monitor should sudden bursts of a regular heart rhythm with a rate of 22 bpm, normal ORS duration, and P waves that are difficult to see? 1. sinus tachycardia 2. atrial fibrillation 3. ventricular tachycardia (VT) 4. paroxysmal supraventricular tachycardia (PSVT)
4
a patient's cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/min. If the bradycardia is symptomatic, the nurse would expect the patient to exhibit: 1. palpitations 2. hypertension 3. warm, flushed skin 4. shortness of breath
4
a patient with sinus bradycardia is prescribed a temporary transcutaneous pacemaker. the nurse explains to the patient that the pacemaker is used to: 1. increase heart rate 2. decrease heart rate 3. stabilize blood pressure 4. improve oxygenation
1
which nursing intervention is important when caring for clients receiving intravenous (IV) digoxin? select all that apply 1. monitor the heart rate closely 2. check the blood levels of digoxin 3. administer the dose over 1 minute 4. monitor the serum potassium level 5. give the medication with other infusion medications
1, 2, 4
a patient'e ECG reveals a heart rate of 110 beats per minute with a regular rhythm and upright P waves preceding each QRS complex. the nurse identifies this rhythm as: 1. sinus tachycardia 2. sinus bradycardia 3. atrial flutter 4. ventricular tachycardia
1
which medication is used to treat a client whose cardiac monitor reveals several runs of ventricular tachycardia? 1. atropine 2. epinephrine 3. amiodarone 4. sodium bicarbonate
3
which clinical manifestation will the nurse assess for in a client with a serum potassium level of 6.4? select all that apply 1. anorexia 2. constipation 3. muscle weakness 4. irregular heart rhythm 5. hyperactive bowel tones
3, 4, 5
during the assessment of a patient with sinus bradycardia, the nurse should prioritize monitoring for which potential complication? 1. hypertension 2. hyperthermia 3. hypoxia 4. hypotension
4
the nurse is assessing an ECG rhythm strip. which component of the tracing will the nurse observe to determine ventricular depolarization? 1. P wave 2. T wave 3. PR interval 4. QRS complex
4
for which client would the nurse anticipate that diltiazem will be prescribed by the health care provider? 1. client A with atrial fibrillation 2. client B with normal sinus rhythm 3. client C with ventricular tachycardia 4. client D with sinus bradycardia
1
which action would the nurse take first when the occupational health nurse is working at a construction site and observes a worker who collapses and is pulseless? 1. ask someone to activate the emergency response system immediately 2. begin chest compressions that depress the sternum at least 2 inches (5 cm) 3. apply the pads for the automatic external defibrillator (AED) that is readily available 4. use a chin lift and head tilt technique and ventilate using a bag-valve-mask system
1
which criteria indicates that a client on a cardiac. monitor is in sinus rhythm>? select all that apply 1. the RR intervals are relatively consistent 2. one P wave precedes each ORS complex 3. the ST segment is higher than the PR interval 4. four to eight complexes occur in a 6 second strip 5. the ORS duration ranges from 0.12 to 0.2 seconds
1, 2
a nurse is assessing a patient and notes a heart rate of 55 beats per minute on the cardiac monitor. The ECG reveals regular P waves, PR intervals, and QRS complexes. the nurse recognizes this rhythm as: 1. sinus tachycardia 2. sinus bradycardia 3. atrial fibrillation 4. atrial flutter
2
a patient is diagnosed with hypovolemia and exhibits sinus tachycardia. the nurse anticipates that the primary treatment will involve: 1. administering an anti arrhythmic medication 2. administering intravenous fluids 3. administering a calcium channel blocker 4. administering an antibiotic
2
which action would the nurse take after reviewing a client's electrocardiogram reading sinus rhythm? 1. have the client perform the Valsalva maneuver 2. document that the client is in sinus rhythm 3. prepare to defibrillate the client at 200 joules 4. advise the client to reduce the intake of caffeine
2
when the nurse needs to determine atrial rate and rhythm, which component of the electrocardiogram will be used? 1. P waves 2. PR intervals 3. T waves 4. QRS complexes
1
which action would the nurse perform when a client is in ventricular fibrillation? select all that apply 1. initiating CPR 2. assessing the EKG 3. using a defibrillator 4. obtaining electrolytes 5. administering epinephrine
1, 2, 3, 4, 5
which client response must the nurse monitor to determine the effectiveness of amiodarone? 1. absence of ischemic chest pain 2. decrease in cardiac dysrhythmias 3. improvement in fasting lipid profile 4. maintenance of blood pressure control
2
when a client's cardiac monitor indicates ventricular tachycardia, which action would the nurse take after identifying an increased apical pules rate from 100 to 150 bpm? 1. administer amiodarone 2. administer epinephrine 3. assist with insertion of a pacemaker 4. administer atropine
1
which action would the nurse take first after obtaining a radial pulse rate of 136 bpm in a client with chronic atrial fibrillation? 1. ask about any new stressors in the client's life 2. take the client's apical pulse for a full minute 3. notify the health care provider about the heart rate 4. ask whether prescribed medications have been taken
2
which clinical finding enables the nurse to conclude that the heparin therapy is effective in a client who has atrial fibrillation with rapid ventricular response and is started on a continuous heparin infusion? 1. atrial fibrillation converts to a sinus rhythm 2. the heart rate is stabilized at 70 to 990 beats per minute 3. the international normalized ratio (INR) is within normal range 4. an activated partial thromboplastin time (aPTT) is twice the usual value
4
which medication is indicated to treat bradycardia for a client whose heart rate drops to 38 bpm during a procedure? 1. digoxin 2. lidocaine 3. amiodarone 4. atropine sulfate
4
which medication is indicated to treat bradycardia for a client whose heart rate drops to 38 bpm during a procedure? 1. digoxin 2. lidocaine 4. amiodarone 4. atropine sulfate
4
which possible dysrhythmia would a nurse anticipate testing for after noting that a client in the clinic has an irregular irregular pulse rhythm at a rate of 88 bpm? 1. atrial fibrillation 2. ventricular tachycardia 3. complete heart block 4. supraventricular tachycardia
1
which assessment after administration of diltiazem to a client with SVT and a heart rate of 170 bpm indicates that the medication was effective? 1. increased urine output 2. blood pressure of 90/60 mm Hg 3. heart rate of 98 bpm 4. no longer complaining of heart palpitations
3
which response would be given by the charge nurse when nurse new to the telemetry flood asks what can be done to decrease the frequent alarms of a client telemetry monitor? 1. "turn off the alarm and take frequent vital signs" 2. "change the alarm parameters to decrease alerts" 3. "follow our clinical alarm policy and check the client" 4. "contact the HCP to discontinue telemetry"
3
which rhythm would the nurse document when observing a rapid, feeble twitching/quivering on a client's cardiac monitor? 1. atrial flutter 2. atrial fibrillation 3. ventricular fibrillation 4. ventricular tachycardia
3
which statement by a staff member after an educational session on the use of adenosine for supraventricular tachycardia indicates that the teaching has been effective? 1. "we will need a crash cart available at the client's bedside" 2. "we will plan to schedule the anesthesiologist to be available" 3. "the medication should be injected over at least 1 to 2 minutes" 4. "infusion of normal saline will be needed before medication injection"
1
a patient was admitted with a rhythm strip that read 40 bpm. if medication were required to treat this rhythm, which medication would the nurse anticipate the provider ordering first? 1. amiodarone 2. adenosine 3. atropine 4. epinephrine
3
when a client on the coronary care unit develops ventricular tachycardia, which action will the nurse take first? 1. initiate immediate defibrillation 2. perform synchronized cardioversion 3. assess client's pulse and blood pressure 4. start cardiopulmonary resuscitation (CPR)
3
when admitting a client with syncope and sinus bradycardia, which medication will the nurse anticipate administering? 1. digoxin 2. enalapril 3. atropine 4. metoprolol
3
which medication indicated fro treatment of ventricular dysrhythmias would a nurse recall when caring for a client whose cardiac monitor indicates multiple multifocal premature ventricular complexes (PVCs)? 1. amiodarone 2. epinephrine 3. methyldopa 4. hydrochlorothiazide
1
which action is essential for the nurse to include in the plan of care for a client with atrial fibrillation? 1. take pulse apically for a full minute 2. monitor blood pressure at least every 2 hours 3. ask client to call for assistance when ambulating 4. teach client to avoid taking over-the-counter aspirin
1
which action would the nurse take next after observing a sinus rhythm in a client who came to the emergency department after experiencing "skipped heartbeats"? 1. obtain the client's blood pressure 2. ask the client about caffeine intake 3. review the client's home medications 4. question the client about alcohol use
1
which action would the nurse take when assessing an infant on digoxin who has an apical pule of 88 bpm? 1. notify the HCP immediately 2. tell the mother to continue giving the digoxin 3. expect the health care provider to lower the dose 4. ask the mother whether this is the infant's usual heart rate
1
which alterations in the usual dosage would the nurse anticipate for a client with cirrhosis of the liver prescribed lidocaine to treat a ventricular dysrhythmia? 1. higher than usual dosage to compensate for the impaired liver function 2. lower than usual dosage because the medication is metabolized at a diminished rate 3. reduced dosage because other organs will compensate for the sluggish liver 4. equal dosage to that needed for other clients but used over a shorter duration
2
which condition would the nurse conclude that the client is experiencing when the monitor shows a PQRST wave for each beat, indicates a rate of 120 bpm, and the rhythm is regular? 1. atrial fibrillation 2. sinus tachycardia 3. ventricular fibrillation 4. first-degree atrioventricular block
2
which description would the nurse use to document the rhythm when a client's cardiac monitor shows a PQRST wave for each beat with a regular rhythm and a rate of 120 bpm? 1. atrial fibrillation 2. sinus tachycardia 3. ventricular fibrillation 4. first-degree atrioventricular block
2
which finding for a client who has a diagnosis of paroxysmal atrial fibrillation is most important to report quickly to the HCP? 1. irregular heartbeat 2. right arm weakness 3. client report of palpitations 4. client report of lightheadedness
2
a patient is admitted with a rhythm strip reading a heart rate of 130 bpm. what is the most appropriate initial nursing intervention? 1. administer a beta-blocker 2. administer atropine 3. administer an antiarrhythmic medication 4. assess the patient's clinical condition and possible causes
4
which action would the nurse take next after cardiopulmonary resuscitation has been started by the code team for an unresponsive hospitalized client? 1. contact the client's primary health care provider 2. move any other clients or visitors out of the room 3. get the client's record and have it available in the room 4. obtain the defibrillator and place paddles on the client's chest
4
which client statement indicates an understanding of the nurse's instructions concerning a Holter monitor? 1. "the only times the monitor should be taken off are for showering and sleep" 2. "the monitor will record my activities and symptoms if an abnormal rhythm occurs" 3. "the results from the monitor will be used to determine the size and shape of my heart" 4. "the motor will record any abnormal heart rhythms while I go about my usual activities"
4