EKG prepU
A monitor technician on the telemetry unit asks a charge nurse why every client whose monitor shows atrial fibrillation is receiving warfarin (Coumadin). 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 clot formation in the atria of clients 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."
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? "Warfarin prevents clot formation in the atria of clients with atrial fibrillation." "Warfarin prevents atrial fibrillation from progressing to a lethal arrhythmia." "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 clot formation in the atria of clients with atrial fibrillation."
After taking an ECG on a 38-year-old woman, the nurse reports that the PR interval reflects normal sinus rhythm. The nurse has made this interpretation based on the PR interval of: 0.05 and 0.1 seconds. 0.15 and 0.3 seconds. 0.25 and 0.4 seconds. 0.12 and 0.2 seconds.
0.12 and 0.2 seconds.
Electrocardiogram (ECG) waveforms are printed on graph paper that is divided by light and dark vertical and horizontal lines at standard intervals. When the nurse is interpreting the heart rhythm, he or she understands that each large block equals how many seconds? 0.1 0.3 0.2 0.4
0.2
Which PR interval presents a first-degree heart block? 0.14 seconds 0.24 seconds 0.16 seconds 0.18 seconds
0.24 seconds
A client with second-degree atrioventricular heart block is admitted to the coronary care unit. The nurse closely monitors the client's heart rate and rhythm. When interpreting the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex represents: atrial depolarization. atrial repolarization. ventricular repolarization. ventricular depolarization.
ventricular depolarization.
A nurse on the telemetry unit is faced with various monitor rhythms. Which rhythm takes priority? A client's monitor shows sinus tachycardia with frequent premature atrial contractions (PACs). A client's cardiac rhythm suddenly changes from normal sinus rhythm to uncontrolled atrial fibrillation. A client's monitor shows frequent paced beats with capture. A client's cardiac monitor suddenly reveals sinus tachycardia with isolated premature ventricular contractions.
A client's cardiac rhythm suddenly changes from normal sinus rhythm to uncontrolled atrial fibrillation
The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle? Early ventricular repolarization Atrial depolarization Ventricular depolarization Ventricular repolarization
Atrial depolarization
A client arrives at the emergency department with a heart rate of 210 beats/minute and the following pattern on the cardiac monitor. The nurse is correct to alert the health care provider to the presence of which disorder? Premature ventricular contraction Ventricular fibrillation Asystole Atrial flutter
Atrial flutter
The treatment for symptomatic junctional rhythm is the same as for which of the following other heart rhythms? Tachycardia Atrial flutter Atrial fibrillation Bradycardia
Bradycardia
A patient has had several episodes of recurrent tachydysrhythmias over the last 5 months and medication therapy has not been effective. What procedure should the nurse prepare the patient for? Maze procedure Catheter ablation therapy Insertion of an ICD Insertion of a permanent pacemaker
Catheter ablation therapy
The nurse is assessing a patient with a probable diagnosis of first-degree AV block. He is aware that this dysrhythmia is evident on an ECG strip by which of the following? Delayed conduction, producing a prolonged PR interval Variable heart rate, usually fewer than 90 bpm P waves hidden within the QRS complex Irregular rhythm
Delayed conduction, producing a prolonged PR interval
The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block? Delayed conduction, producing a prolonged PR interval An irregular rhythm P waves hidden with the QRS complex A variable heart rate, usually fewer than 60 bpm
Delayed conduction, producing a prolonged PR interval
Sam, a retired professional NFL player, visits his cardiologist for his annual physical. The nurse takes an ECG and notices an abnormal finding. However, the nurse realizes that this result can be normal when present without symptoms. This finding is a: P-to-QRS ratio of 1:1. Heart rate of 42 beats per minute (bpm). PR interval of 0.18 seconds. QT interval of 0.37 seconds.
Heart rate of 42 beats per minute (bpm)
A client is taking spironolactone to control her hypertension. Her serum potassium level is [6 mEq/L (56mmol/L)]. For this client, the nurse's priority should be to assess her: electrocardiogram (ECG) results. neuromuscular function. bowel sounds. respiratory rate.
I think ECG :)
A client is treated in the intensive care unit (ICU) following an acute myocardial infarction (MI). During the nursing assessment, the client reports shortness of breath and chest pain. In addition, the client's blood pressure (BP) is 100/60 mm Hg with a heart rate (HR) of 53 bpm, and the electrocardiogram (ECG) tracing shows more P waves than QRS complexes. Which action should the nurse complete first? Administer 1 mg of IV atropine Initiate transcutaneous pacing Prepare for defibrillation Obtain a 12-lead ECG
Initiate transcutaneous pacing
The nurse is placing electrodes for a 12-lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1? Mid-clavicular line, fifth intercostal space Right side of sternum, fourth intercostal space Left side of sternum, fourth intercostal space Midway between V2 and V4
Right side of sternum, fourth intercostal space
A 26-year-old client, who has been diagnosed with paroxysmal supraventricular tachycardia (PSVT), is treated in the emergency department. The client is experiencing occasional runs of PSVT lasting up to several minutes at a time. During these episodes, the client becomes lightheaded but does not lose consciousness. Which maneuver(s) may be used to interrupt the client's atrioventricular nodal reentry tachycardia (AVNRT)? Select all that apply. Instructing the client to breathe deeply Placing the client's face in cold water Instructing the client to vigorously exercise Performing carotid massage Stimulating the client's gag reflex
Stimulating the client's gag reflex Performing carotid massage Placing the client's face in cold water
The nurse is caring for a client with atrial fibrillation. The client's symptoms started about 1 week ago, but he is just now seeking medical attention. The client asks the nurse why he has to wait several weeks before the cardioversion takes place. The best answer by the nurse is which of the following? "Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion." "The doctor wants to see if your heart will switch back to its normal rhythm by itself." "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."
A client has been diagnosed with atrial fibrillation. The health care provider (HCP) prescribed warfarin to be taken on a daily basis. The nurse instructs the client to avoid using which over-the-counter medication while taking warfarin? pseudoephedrine digoxin diphenhydramine aspirin
aspirin
A client is diagnosed with myocardial infarction. Which data collection findings indicate that the client has developed left-sided heart failure? Select all that apply. Hepatomegaly Cough Crackles Ascites Orthopnea Jugular vein distention
cough, crackles, orthopnea
A physician orders esmolol for a client with supraventricular tachycardia. During esmolol therapy, the nurse should monitor the client's: body temperature. ocular pressure. cerebral perfusion pressure. heart rate and blood pressure
heart rate and blood pressure.
A client is admitted with a myocardial infarction and atrial fibrillation. While auscultating the heart, the nurse notes an irregular heart rate and hears an extra heart sound at the apex after the S2 that remains constant throughout the respiratory cycle. The nurse should document these findings as: heart rate irregular with mitral stenosis. heart rate irregular with S4. heart rate irregular with S3. heart rate irregular with aortic regurgitation.
heart rate irregular with S3.
A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute. What type of dysrhythmia does the client have? atrial bradycardia heart block none sinus bradycardia
i think...sinus bradycardia
The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as junctional tachycardia. normal sinus rhythm. sinus tachycardia. first-degree atrioventricular block.
normal sinus rhythm.
A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What type of dysrhythmia would the cardiologist likely diagnose? supraventricular tachycardia supraventricular bradycardia sinus bradycardia sinus tachycardia
sinus tachycardia
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? Atrial flutter Ventricular fibrillation Premature ventricular contraction Asystole
Atrial flutter
Electrocardiogram (ECG) characteristics of atrial fibrillation include which of the following? P wave resent before each QRS Normal PR interval Regular rhythm Atrial rate of 300 to 400
Atrial rate of 300 to 400
Which medication is the drug of choice for sinus bradycardia? Lidocaine Atropine Cardizem Pronestyl
Atropine
The nurse analyzes the electrocardiogram (ECG) strip of a stable patient admitted to the telemetry unit. The client's ECG strip demonstrates PR intervals that measure 0.24 seconds. What is the nurse's most appropriate action? Notify the client's primary care provider of the findings Document the findings and continue to monitor the patient Apply oxygen via nasal cannula and obtain a 12-lead ECG Instruct the client to bear down as if having a bowel movement
Document the findings and continue to monitor the patient
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? Measure the client's blood pressure. Suggest the need for a new beta-blocker to the doctor. Do nothing; there is no cause for alarm. Double-check the monitoring equipment.
Double-check the monitoring equipment.
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? "Don't worry. All resuscitation equipment is kept nearby when these procedures are being done." "Everything will turn out fine; do not worry about your heart cells." "The doctor knows best; just let her worry about which heart cells to destroy." "Only the specific cells causing your dysrhythmia are destroyed; your heart will function better without these cells."
Only the specific cells causing your dysrhythmia are destroyed; your heart will function better without these cells."
A client admitted to the telemetry unit has a serum potassium level of 6.6 mEq/L. Which electrocardiographic (ECG) characteristic is commonly associated with this laboratory finding? Peaked T waves Occasional U waves Flattened P waves Prolonged QT interval
Peaked T waves
The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond? Inform the physician that the patient is experiencing a new onset of dysrhythmia. Inform the technician that the ECG equipment has malfunctioned. Recognize that the view of the electrical current changes in relation to the lead placement. Recognize that the electrophysiological conduction of the heart differs with lead placement.
Recognize that the view of the electrical current changes in relation to the lead placement.
A nurse is teaching a client who will soon be discharged with a prescription for warfarin. Which statement should the nurse include in discharge teaching? "This drug will dissolve any clots you may still have." "If you miss a dose, double the next dose." "Eat more yogurt and broccoli." "Don't take aspirin while you're taking warfarin."
"Don't take aspirin while you're taking warfarin."
A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? "I'll use an electric razor to shave." "I'll eat four servings of fresh, dark green vegetables every day." "I'll watch my gums for bleeding when I brush my teeth." "I'll report unexplained or severe bruising to my doctor right away."
"I'll eat four servings of fresh, dark green vegetables every day."
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 80 bpm. 90 bpm. 70 bpm. 100 bpm.
90 bpm
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? Sawtooth Square Sinusoidal Triangular
Sawtooth
Two nursing students are reading EKG strips. One of the students asks the instructor what the P-R interval represents. The correct response should be which of the following? "It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node." "It shows the time it takes the AV node impulse to depolarize the ventricles and travel through the SA node." "It shows the time it takes the AV node impulse to depolarize the septum and travel through the Purkinje fibers." "It shows the time it takes the AV node impulse to depolarize the atria and travel through the SA node."
"It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node."
A nursing student working today on the cardiac unit asks the instructor why loss of the "atrial kick" causes a decrease in cardiac output, because ventricles are still contracting. The instructor's best answer is which of the following? "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." "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 contraction fills the ventricles and accounts for nearly one third of the volume ejected during ventricular contraction."
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? shock All options are correct. strenuous exercise elevated temperature
All options are correct.
To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform? P wave PR interval QRS complex T wave
P wave
A client has a heart rate greater than 155 beats/minute and the ECG shows a regular rhythm with a rate of 162 beats/minute. The client is intermittently alert and reports chest pain. P waves cannot be identified. What condition would the nurse expect the physician to diagnose? sinus tachycardia supraventricular tachycardia heart block atrial flutter
supraventricular tachycardia
The nurse is caring for clients on a telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart? Altered patterns frequently turn into life-threatening arrhythmias. Altered patterns frequently affect the heart's ability to pump blood effectively. Altered patterns frequently produce neurological deficits. Altered patterns frequently cause a variety of home safety issues.
Altered patterns frequently affect the heart's ability to pump blood effectively.
The nurse and student nurse are observing a cardioversion procedure completed by a physician. At which time is the nurse most correct to identify to the student when the electrical current will be initiated? During repolarization of the heart During the QRS complex During ventricular depolarization During stimulation of the SA node
During ventricular depolarization
Which term is used to describe a tachycardia characterized by abrupt onset, abrupt cessation, and a QRS of normal duration? Sinus tachycardia Atrial flutter Paroxysmal atrial tachycardia Atrial fibrillation
Paroxysmal atrial tachycardia
The nurse is teaching a beginning EKG class to staff nurses. As the nurse begins to discuss the the parts of the EKG complex, one of the students asks what the normal order of conduction through the heart is. The correct response would be which of the following? Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers AV node, SA node, bundle of His, right and left bundle branches, and the Purkinje fibers SA node, AV node, bundle of His, the Purkinje fibers, and the right and left bundle branches SA node, AV node, right and left bundle branches, bundle of His, and the Purkinje fibers
Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers
A patient comes to the emergency department with complaints 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 Sinus tachycardia Ventricular tachycardia Normal sinus rhythm
Sinus tachycardia
A nurse just received a shift report for a group of clients on the telemetry unit. Which client should the nurse assess first? The client admitted with first-degree atrioventricular (AV) block whose cardiac monitor now reveals type II second-degree AV block The client with a history of heart failure who has bibasilar crackles and pitting edema in both feet The client admitted for unstable angina who underwent percutaneous coronary intervention (PCI) with stenting yesterday The client with a history of cardioversion for sustained ventricular tachycardia 2 days ago
i think...The client admitted with first-degree atrioventricular (AV) block whose cardiac monitor now reveals type II second-degree AV block
A client with second-degree atrioventricular heart block is admitted to the coronary care unit. The nurse closely monitors the client's heart rate and rhythm. When interpreting the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex represents: ventricular depolarization. atrial depolarization. ventricular repolarization. atrial repolarization.
ventricular depolarization.
