Nurs 332 Week 5 Ch 26 ML
Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation? A. Potassium supplement B. Anticoagulant C. Diuretic D. Antihypertensive
B
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? A. Left side of sternum, fourth intercostal space B. Right side of sternum, fourth intercostal space C. Mid-clavicular line, fifth intercostal space D. Midway between V2 and V4
B
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? A. Second degree, type II B. Third degree C. Second degree, type I D. First degree
B
When the appropriate electrocardiogram (ECG) complex follows the pacing spike, it is said to be A. nonsynchronous. B. captured. C. triggered. D. inhibited.
B
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? A. Alerting the healthcare provider of the third-degree heart block B. Assessing the client's blood pressure and heart rate frequently C. Identifying the client's code level status D. Maintaining the client's intravenous fluids
A
The nurse knows that what PR interval presents a first-degree heart block? A. 0.24 seconds B. 0.18 seconds C. 0.16 seconds D. 0.14 seconds
A
The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia? A. Heart rate of 42 beats per minute (bpm). B. QR interval of 0.25 seconds. C. PR interval of 0.24 seconds. D. P-to-QR ratio of 1:2.
A
The licensed practical nurse is monitoring the waveform pattern on the cardiac monitor of the client admitted following a myocardial infarction. The nurse notes that every other beat includes a premature ventricular contraction (PVC). The nurse notes which of the following in the permanent record? A.Multifocal PVCs B. Bigeminy C. Couplets D. R-on-T phenomenon
B
The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia? A. hypothyroidism B. hypovolemia C. digoxin D. vagal stimulation
B
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? A. Question the client about alcohol and illicit drug use. B. Instruct the client to hold the breath and bear down. C. Prepare to administer a calcium channel blocker. D. Place the client on supplemental oxygen.
A
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? A. internal cardioverter defibrillator insertion B. pacemaker insertion C. radiofrequency ablation D. electrophysiological study
A
A home care nurse is visiting a left-handed client who has an implantable cardioverter-defibrillator (ICD) implanted in the left chest. The client is planning to go rifle hunting. How should the nurse respond? A. "You can't shoot a rifle left-handed because the rifle's recoil will traumatize the ICD site." B. "You'll need to take an extra dose of your antiarrhythmic before you shoot." C. "Being that close to a rifle might make your ICD fire." D. "Enjoy your hunting trip."
A
A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response? A. Document the findings and continue to monitor the client B. Check the security of all connections and increase the milliamperage C. Reposition the extremity and turn the client to left side D. Obtain a 12-lead ECG and a portable chest x-ray
A
A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching? A. "I'll keep a log of each time my ICD discharges." B. "I need to stay at least 10 inches away from the microwave." C. "I can't wait to get back to my football league." D. "I have an appointment for magnetic resonance imaging of my knee scheduled for next week."
A
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? A. The registered nurse administering atropine sulfate intravenously D. The registered nurse stating to administer digoxin C. The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute D. The registered nurse stating to administer all medications except those which are cardiotonics
A
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? A. During ventricular depolarization B. During the QRS complex C. During repolarization of the heart D. During stimulation of the SA node
A
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia? A. Defibrillation B. Elective cardioversion C. Pacemaker implantation D. Maze procedure
B
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? A. "It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node." B. "It shows the time it takes the AV node impulse to depolarize the septum and travel through the Purkinje fibers." C. "It shows the time it takes the AV node impulse to depolarize the ventricles and travel through the SA node." D. "It shows the time it takes the AV node impulse to depolarize the atria and travel through the SA node."
A
When the nurse observes an electrocardiogram (ECG) tracing on a cardiac monitor with a pattern in lead II and observes a bizarre, abnormal shape to the QRS complex, the nurse has likely observed which of the following ventricular dysrhythmias? A. Premature ventricular contraction (PVC) B. Ventricular fibrillation C. Ventricular bigeminy D. Ventricular tachycardia
A
When the nurse observes that the client's heart rate increases during inspiration and decreases during expiration, the nurse reports that the client is demonstrating A. sinus dysrhythmia. B. sinus bradycardia. C. normal sinus rhythm. D. sinus tachycardia.
A
Which is not a likely origination point for cardiac dysrhythmias? A. bundle of His B. atria C. ventricles D. atrioventricular node
A
Which term is used to describe a tachycardia characterized by abrupt onset, abrupt cessation, and a QRS of normal duration? A. Paroxysmal atrial tachycardia B. Atrial fibrillation C. Sinus tachycardia D. Atrial flutter
A
A nursing instructor is reviewing the parts of an EKG strip with a group of students. One student asks about the names of all the EKG cardiac complex parts. Which of the following items are considered a part of the cardiac complex on an EKG strip? Choose all that apply. A. P wave B. S-Q segment C. QRT wave D. P-R interval E. T wave
A, D, E
The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block? A. A variable heart rate, usually fewer than 60 bpm B. Delayed conduction, producing a prolonged PR interval C. An irregular rhythm D. P waves hidden with the QRS complex
B
Which of the following does the nurse recognize as the therapeutic goal of radiofrequency catheter ablation for a client with cardiac dysrhythmias? A. Reperfusion of ischemic heart tissue B. Destruction of errant tissue C. Dilation of arterial blood vessels D. Stimulation of the impulse center
B
A client asks the nurse what causes the heart to be an effective pump. The nurse informs the client that this is due to the: A. inherent electrons in muscle tissue. B. inherent rhythmicity of cardiac muscle tissue. C. inherent rhythmicity of all muscle tissue. D. sufficient blood pressure.
B
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? A. Administer 1 mg of IV atropine B. Initiate transcutaneous pacing C. Obtain a 12-lead ECG D. Prepare for defibrillation
B
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? A. Scar on the chest B. "Spike" on the rhythm strip C. Vibration under the skin D. Quality of the pulse
B
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? A. Normal sinus rhythm B. Sinus tachycardia C. Ventricular tachycardia D. Sinus bradycardia
B
The staff educator is teaching a class in dysrhythmias. What statement is correct for defibrillation? A. The client is sedated before the procedure. B. It uses less electrical energy than cardioversion. C. It is used to eliminate ventricular dysrhythmias. D. It is a scheduled procedure 1 to 10 days in advance.
C
To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform? A. T wave B. PR interval C. P wave D. QRS complex
C
Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves? A. Ventricular fibrillation B. Atrial fibrillation C. Atrial flutter D. Ventricular tachycardia
C
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? A. "The QRS complex will be smaller in sinus bradycardia." B. "The P-R interval will be prolonged in sinus bradycardia." C. "The only difference is the heart rate." D. "The P waves will be shaped differently."
C
A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to A. apply supplemental oxygen. B. request sublingual nitroglycerin. C. avoid caffeinated beverages. D. lie down and elevate the feet.
C
A client with a second-degree atrioventricular heart block, Type II is admitted to the coronary care unit. How will the nurse explain the need to monitor the client's electrocardiogram (ECG) strip to the spouse? A. "When your spouse needs help, an alarm will go off at the desk." B. "The box is recording the heart's electrical activity, and a physician will review the tracing later." C. "The small box will transmit the heart rhythm to the central monitor all the time." D. "The heart's electrical activity will be recorded when the heart rate exceeds 60 beats per minute."
C
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? A. elevated temperature B. shock C. All options are correct. D. strenuous exercise
C
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? A. Lidocaine B. Amiodarone C. Atropine D. Dobutamine
C
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? A. Decreased blood pressure with reflex tachycardia B. Decreased peripheral vascular resistance C. Decreased cardiac output and decreased systolic and diastolic blood pressure D. Increased cardiac output and increased systolic and diastolic blood pressure
C
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. An ECG machine B. A suction machine C. A defibrillator D. Cardioversion equipment
C
The nurse analyzes the electrocardiogram (ECG) tracing of a client newly admitted to the cardiac step-down unit with a diagnosis of chest pain. Which finding indicates the need for follow-up? A. ST segment that is isoelectric in appearance B. PR interval that is 0.18 seconds long C. QT interval that is 0. 46 seconds long D. QRS complex that is 0.10 seconds long
C
The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client? A. Hypotension B. Nausea C. Fluttering D. Fever
C
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? A. identifying a code-level status B. assessing blood pressure and heart rate frequently C. alerting the healthcare provider of the third-degree heart block D. maintaining intravenous fluids
C
The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what? A. P wave resent before each QRS B. Normal PR interval C. Atrial rate of 300 to 400 D. Regular rhythm
C
Which nursing intervention is required to prepare a client with cardiac dysrhythmia for an elective electrical cardioversion? A. Facilitate CPR until the client is prepared for cardioversion B. Administer digitalis and diuretics 24 hours before cardioversion C. Instruct the client to restrict food and oral intake D. Monitor blood pressure every 4 hours
C
Which postimplantation instruction must a nurse provide to a client with a permanent pacemaker? A. Keep moving the arm on the side where the pacemaker is inserted B. Delay activities such as swimming and bowling for at least 3 weeks C. Avoid sources of electrical interference D. Keep the arm on the side of the pacemaker higher than the head
C
The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include? A. It is not necessary to learn how to take your own pulse. B. Do not be concerned if you experience symptoms of lightheadedness and dizziness. C. If you miss a dose of your antiarrhythmic medication, double up on the next dose. D. Your family and friends may want to take a CPR class.
D
The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what? A. P wave resent before each QRS B. Normal PR interval C. Regular rhythm D. Atrial rate of 300 to 400
D
A client with an atrial dysrhythmia has come to the clinic for a follow-up appointment and to talk with the health care provider about options to stop this dysrhythmia. What procedure could be used to treat this client? A. Chemical cardioversion B. Elective electrical defibrillation C. Mace procedure D. Elective electrical cardioversion
D
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 A. Ventricular tachycardia B. Ventricular fibrillation C. Atrial fibrillation D. Atrial flutter
D
A nurse is caring for a client who has been admitted to have a cardioverter defibrillator implanted. The nurse knows that implanted cardioverter defibrillators are used in which clients? A. Clients with recurrent life-threatening bradycardias B. Clients with sinus tachycardia C. Clients with ventricular bradycardia D. Clients with recurrent life-threatening tachydysrhythmias
D
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? A. Provide electrical cardioversion B. Administer intravenous epinephrine C. Prepare for endotracheal intubation D. Begin cardiopulmonary resuscitation
D
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? A. Sinus bradycardia B. Ventricular tachycardia C. Normal sinus rhythm D. Sinus tachycardia
D
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? A. Early ventricular repolarization B. Ventricular repolarization C. Ventricular depolarization D. Atrial depolarization
D
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? A. TP interval B. QT interval C. PP interval D. RR interval
D
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? A. "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal." B. "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width." C. "The two look very much alike; it is difficult to tell the difference." D. "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."
D
Which electrocardiogram (ECG) characteristic is usually seen when a client's serum potassium level is low? A. QT interval B. T wave C. P wave D. U wave
D
Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?
Monitor vital signs and cardiac rhythm
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? A. "The F waves are most likely caused by the new medication." B. "The F waves are flutter waves representing ventricular activity." C. "The F waves are flutter waves representing atrial activity." D. "The F waves are normal parts of the heart conduction system"
c
The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm below. What dysthymia should the nurse document?
ventricular tachycardia