Ch 39 Dysrhythmias EAQ

Which sondition is a possinle cause of the artifact in a patient's EKG tracing? Select all that apply. A. the patient is shivering B. the patient has dry skin C. the conductive gel is moist D. electrical interference is present E. the leads and electrodes are not secure

A. the patient is shivering D. electrical interference is present E. the leads and electrodes are not secure

A patient has pulseless ventricular tachycardia, and cardiopulmonary resuscitation is in progress. Which step would the nurse take first after a defibrillator is available? A. turn on the device B. analyze the rhythm C. apply conductive gel pads D. select proper energy setting

A. turn on the device

Defibrillation is indicated for which dysrhythmia? A. v fib B. uncontrolled afib C. v tach with a pulse D. 3rd degree av block

A. v fib

Which condition is an indication for a patient to have a permanent pacemaker implanted? Select all that apply. A. Cardiomyopathy B. SA node dysfunction C. Coronary angioplasty D. 3rd degree AV block E. new drug therapy that may cause bradycardia

A. Cardiomyopathy B. SA node dysfunction D. 3rd degree AV block

Which time period does the T wave in an EKG represent? A. ventricular repolarization B. depolarization of both ventricles C. passage of the electrical impulse through the atrium D. time between ventricular depolarization and repolarization

A. ventricular repolarization

The nurse is reviewing discharge instructions with a patient who received and implantable cardioverter-defribrillator (ICD). Which patient statement indicates the need for further teaching? A. I should avoid flying for 3 years B. I should avoid direct blows to the ICD site C. I should avoid standing near antitheft devices in doorways D. I should avoid large magnets and strong electromagnetic fields

A. I should avoid flying for 3 years

Which cardiac problem is an indication for placement of a permanent pacemaker? A. heart failure B. edema after open-heart surgery C. acute inferior myocardial infarction D. evaluation of tachydysrhythmias

A. heart failure

Which is the most common electrocardiograph lead selected for continuous monitoring? Select all that apply. A. lead II B. Lead III C. Lead V1 D. Lead V6 E. Lead aVR

A. lead II C. Lead V1

The nurse provides education to a group of nursing students about cardiac conditions that are common causes of dysrhythmias. Which condition would the nurse include in the teaching? Select all that apply. A. Valve disease B. emotional crisis C. conduction defects D. Accessory pathways E. electrolyte imbalances

A. Valve disease C. conduction defects D. Accessory pathways

The nurse is preparing a patient for an EKG. When placing the six unipolar chest leads, at which position should the nurse place the V6 lead? A. fifth intercostal space at the left midaxillary line B. fifth intercostal space at the left midclavicular line C. fifth intercostal space at the left anterior axillary line D. fourth intercoastal space at the right sternal border

A. fifth intercostal space at the left midaxillary line

A patient has sought care following a syncopal episode of unknown etiologyg. Which item will be included in the patient's treatment plan? A. head up tilt test B. IV beta adrenergic blocker C. pacemaker insertion D. antiplatelet therapy

A. head up tilt test

Which statement is accurate regarding the role of the ANS in impulse formation? A. Stimulation of the parasympathetic nerves increases cardiac contractility B. Stimulation of the vagus nerve causes decreased rate of firing of the SA node C. Stimulation of the sympathetic nerves decreases the AV node impulse conduction D. Stimulation of the vagus nerve causes increased impulse conduction of the AV node

B. Stimulation of the vagus nerve causes decreased rate of firing of the SA node

Which cardiac activity is absent when a permanent pacemaker fails to capture? A. spontaneous atrial activity B. atrial or ventricular contraction C. spontaneous ventricular activity D. excitability during the cardiac cycle

B. atrial or ventricular contraction

Which term used for the property of heart cells to initiate an impulse spontaneously and continuously? A. exceitability B. Automaticity C. conductivity D. contractibility

B. automaticity

The nurse provides education to a group of nursing students about nonemergent synchronized cardioversion. Which statement made by a student indicates effective learning? A. the shock is delivered on the p wave B. cardioversion is designed to stop the heart briefly C. adenosine is given before the procedure for sedation D. after cardioversion, medications regulate the heart rhythm are no longer needed

B. cardioversion is designed to stop the heart briefly

An experienced nurse teaches a group of new grad nurses about temporary pacemakers. Which information would the nurse include about indications for a temporary pacemaker? Select all that apply. A. heart failure B. prophylaxis after open heart surgery C. afib with SVR D. Acute anterior MI with 2nd or 3rd deg AV block E. acute inferior MI with symptomatic bradycardia and AV block

B. prophylaxis after open heart surgery D. Acute anterior MI with 2nd or 3rd deg AV block E. acute inferior MI with symptomatic bradycardia and AV block

Which type of dysrhythmia is associated with fever? A. a fib B. sinus tachy C. sinus brady D. junctional tach

B. sinus tachy

Which medication is used to manage a complication of afib? A. digoxin B. warfarin C. diltiazem D. metoprolol

B. warfarin

The nurse is caring for a patient 24 hours after the patient underwent pacemaker insertion surgery. Which action will be included on the post op plan of care? A. changing the surgical dressing as needed B. encouraging ROM exercises of the involved arm C. Assessing the incision for any redness, swelling, or discharge D. applying wet to dry dressings every 4 hours to the insertion site

C. Assessing the incision for any redness, swelling, or discharge

The EKG of a patient indicates P waves that are hidden in the preceding T waves and normal QRS complexes. Which condition is the patient experiencing? A. V fib B. junctional dysrhythmia C. PAC D. PVC

C. PAC

Which statement made by the student nurse indicates the need for additional teaching about EKGs? A. Leads I, II, and III are bipolar B. Leads aVR, aVL, and aVF are unipolar C. Six bipolar leads (V1 through V6) measure the electrical forces in the horizontal plane D. A 12-lead EKG may show changes that suggest an electrolyte imbalance

C. Six bipolar leads (V1 through V6) measure the electrical forces in the horizontal plane

Which type of arrhythmia is associated with the absence of p waves on an EKG? A. sinus tachy B. sinus brady C. V fib D. Type II second degree AV block

C. V fib

A patient develops symptomatic sinus tachycardia. Which drug will liekly be included in the patient's treatment plan? A. atropine B. dopamine C. adenosine D. epinephrine

C. adenosine

Which action does flecainide have on the heart? A. accelerates repolarization B. decreases automaticity C. decreases impulse conduction D. reduces myocardial contractility

C. decreases impulse conduction

A patient with a heart rate of 120 beats.min is prescribed an antidysrhythmic drug. Which diag test would the nurse anticipate the patient having? A. holter monitoring B. exercise treadmill testing C. electrophysiologic study (EPS) D. signal-averaged EKG

C. electrophysiologic study (EPS)

Symptomatic type II 2nd degree heart block can be managed with which procedure? A. ablation B. cardioversion C. pacemaker insertion D. cardiac catheterization

C. pacemaker insertion

Which EKG characteristic is consistent with v tach? A. unmeasurable rate and rhythm B. rate 140 beats/minute; inverted p wave C. rate 200 beats/minute; p wave not visible D. rate 125 beats/minute; normal QRS complex

C. rate 200 beats/minute; p wave not visible

Which phrase describes the electrical activity represented by the PR interval on an EKG? A. the length of time it takes to depolarize the atrium B. the length of time it takes for the atria to depolarize and repolarize C. the length of time for the electrical impulse to travel from the SA node to the purkinje fibers D. the length of time it takes for the electrical impulse to travel fromt he SA node to the AV node

C. the length of time for the electrical impulse to travel from the SA node to the purkinje fibers

The nurse provides teaching to a group of nursing students about radiofrequency catheter ablation therapy. Which information would the nurse include? A. the procedure has a high complication rate B. the procedure is done before EPS C. the therapy uses electrical energy to remove problematic areas of the heart's conduction system D. the therapy is considered the nonpharmacological tx of choice for severe bradycardia heart rhythms

C. the therapy uses electrical energy to remove problematic areas of the heart's conduction system

Which type of dysrhythmia is treated with a pacemaker? A. a fib B. sinus tach C. v fib D. 3rd degree av block

D. 3rd degree av block

Which statement describes a disadvantage of a centralized monitoring system? A. it measures the patients' heart rate remotely B. it cannot diagnose dysrhythmias C. it cannot rapidly detect myocardial ischemia D. It requires continuous observation of patients' EKG

D. It requires continuous observation of patients' EKG

Which EKG characteristic in a patient with ACS suggests myocardial ischemia? A. Sinus arrhythmia B. normal T wave C. pathologic q wave D. St segment depression

D. St segment depression

Which heart rate would the nurse expect in a patient with PSVT? A. slower than 60 beats/min B. between 61 and 100 beats/min C. between 101 and 150 beats/min D. between 151 and 220 beats/min

D. between 151 and 220 beats/min

Which property of the heart cells is defined as the ability of the heart to respond mechanically to an impulse? A. automaticity B. excitability C. conductivity D. contractility

D. contractility

Which factor contributes to artifact on a patient's telemetry monitor? A. disabled automaticity B. stimulation of the vagus nerve fibers C. electrodes placed in the incorrect lead D. excessive hair under the electrode pads

D. excessive hair under the electrode pads

A patient is experiencing atrial flutter. Which treatment will be included in the patient's plan of care? A. carotid massage B. the maze procedure C. anticholinergic drugs D. radiofrequency catheter ablation

D. radiofrequency catheter ablation

In which order do the electrical impulses travel through the heart?

SA node internodal pathways AV node Bundle of His Purkinje fibers