Saunders Cardiac Questions

A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? 1.It can develop into ventricular fibrillation at any time. 2.It is almost impossible to convert to a normal rhythm. 3.It is uncomfortable for the client, giving a sense of impending doom. 4.It produces a high cardiac output with cerebral and myocardial ischemia.

1.

The nurse is caring for a client with cardiac disease who has been placed on a cardiac monitor. The nurse notes that the client has developed atrial fibrillation and has a rapid ventricular rate of 150 beats/minute. The nurse should next assess the client for which finding? 1.Hypotension 2.Flat neck veins 3.Complaints of nausea 4.Complaints of headache

1.

The nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead, there are fibrillatory waves before each QRS complex. How should the nurse interpret the client's heart rhythm? 1.Atrial fibrillation 2.Sinus tachycardia 3.Ventricular fibrillation 4.Ventricular tachycardia

1.

The client has developed atrial fibrillation, with a ventricular rate of 150 beats per minute. The nurse should assess the client for which associated signs and/or symptoms? (Select all that apply.) 1.Syncope 2.Dizziness 3.Palpitations 4.Hypertension 5.Flat neck veins

1. 2. 3.

A client is at risk for vasovagal attacks that cause bradydysrhythmias. The nurse would tell the client to avoid which actions to prevent this occurrence? (Select all that apply.) 1.Applying pressure on the eyes 2.Raising the arms above the head 3.Taking stool softeners on a daily basis 4.Bearing down during a bowel movement 5.Simulating a gag reflex when brushing the teeth

1. 2. 4. 5.

A client is scheduled for elective cardioversion to treat chronic high-rate atrial fibrillation. Which finding indicates that further preparation is needed for the procedure? 1.The client's digoxin has been withheld for the last 48 hours. 2.The client is wearing a nasal cannula delivering oxygen at 2 L/min. 3.The defibrillator has the synchronizer turned on and is set at 120 joules (J). 4.The client has received an intravenous dose of a conscious sedation medication.

2.

The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse should assess which item based on priority? 1.Anxiety level of the client and family 2.Activation status and settings of the device 3.Presence of a MedicAlert card for the client to carry 4.Knowledge of restrictions on postdischarge physical activity

2.

A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first? 1.Obtain a 12-lead electrocardiogram. 2.Check the client's fingerstick blood glucose level. 3.Auscultate the client's apical pulse and blood pressure. 4.Measure the QRS interval duration on the rhythm strip.

3.

A client is having frequent premature ventricular contractions. The nurse should place priority on assessment of which item? 1.Causative factors, such as caffeine 2.Sensation of fluttering or palpitations 3.Blood pressure and oxygen saturation 4.Precipitating factors, such as infection

3.

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. The nurse determines that the client is receiving the therapeutic effect based on which results? 1.Prothrombin time of 12.5 seconds 2.Activated partial thromboplastin time of 28 seconds 3.Activated partial thromboplastin time of 60 seconds 4.Activated partial thromboplastin time longer than 120 seconds

3.

The nurse is watching the cardiac monitor and notices that a client's rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140 beats per minute. The nurse determines that the client is experiencing which dysrhythmia? 1.Sinus tachycardia 2.Ventricular fibrillation 3.Ventricular tachycardia 4.Premature ventricular contractions

3.

The nurse notes that a client's cardiac rhythm shows absent P waves, no PR interval, and an irregular rhythm. How should the nurse interpret this rhythm? 1.Bradycardia 2.Tachycardia 3.Atrial fibrillation 4.Normal sinus rhythm (NSR)

3.

A client has received antidysrhythmic therapy for the treatment of premature ventricular contractions (PVCs). The nurse evaluates this therapy as most effective if which finding is noted with regard to the PVCs? 1.They occur in pairs. 2.They appear to be multifocal. 3.They fall on the second half of the T wave. 4.They decrease to a frequency of less than 6 per minute.

4.

A client in sinus bradycardia, with a heart rate of 45 beats per minute and blood pressure of 82/60 mm Hg, reports dizziness. Which intervention should the nurse anticipate will be prescribed? 1.Administer digoxin. 2.Defibrillate the client. 3.Continue to monitor the client. 4.Prepare for transcutaneous pacing.

4.

A client in ventricular fibrillation is about to be defibrillated. To convert this rhythm effectively, the monophasic defibrillator machine should be set at which energy level (in joules, J) for the first delivery? 1.50 J 2.120 J 3.200 J 4.360 J

4.

A client with a complete heart block has had a permanent demand ventricular pacemaker inserted. The nurse assesses for proper pacemaker function by examining the electrocardiogram (ECG) strip for the presence of pacemaker spikes at what point? 1.Before each P wave 2.Just after each P wave 3.Just after each T wave 4.Before each QRS complex

4.

A client with an acute respiratory infection is admitted to the hospital with a diagnosis of sinus tachycardia. Which nursing action should be included in the client's plan of care? 1.Limiting oral and intravenous fluids 2.Measuring the client's pulse each shift 3.Providing the client with short, frequent walks 4.Eliminating sources of caffeine from meal trays

4.

The nurse is assisting to defibrillate a client in ventricular fibrillation. After placing the pads on the client's chest and before discharging the device, which intervention is a priority? 1.Ensure that the client has been intubated. 2.Set the defibrillator to the "synchronize" mode. 3.Administer an amiodarone bolus intravenously. 4.Confirm that the rhythm is ventricular fibrillation.

4.