312 Adaptive Quiz CH. 26

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."

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?

"Spike" on the rhythm strip

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?

"The only difference is the heart rate."

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?

"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity?

"You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."

The nurse is working with a client with a new onset of atrial fibrillation during a three-month follow-up visit. The healthcare provider is planning a cardioversion, and the client asks the nurse why there is a wait for the treatment. What is the best response by the nurse?

"Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion."

After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm?

0.12 and 0.2 seconds.

The nurse knows that what PR interval presents a first-degree heart block?

0.24 seconds

The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?

A client with atrial dysrhythmias

The nurse is in the mall and observes a client slump to the floor. The nurse assesses the client and notes no pulse. The nurse calls for assistance to others in the mall and requests which piece of equipment?

An automatic external defibrillator

The nurse is working on a telemetry unit, caring for a client who develops dizziness and a second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention?

Administer an IV bolus of atropine.

Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?

Anticoagulant

The nurse noted a consistent pattern of heart rate recordings between 48 and 58 bpm over a 24-hour period of time. What medication will cause bradycardia?

Atenolol

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

The nurse is monitoring a patient in the postanesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm?

Atrial flutter

Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves?

Atrial flutter

Which medication is the drug of choice for sinus bradycardia?

Atropine

A nurse is caring for a client who has had an automatic cardiac defibrillator implanted. What instructions should the nurse provide to the client?

Avoid devices with a magnetic field.

Which postimplantation instruction must a nurse provide to a client with a permanent pacemaker?

Avoid sources of electrical interference

The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client?

Avoid undergoing magnetic resonance imaging (MRI).

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?

Clients with recurrent life-threatening tachydysrhythmias

The nurse knows that a pacemaker is the treatment of choice for what cardiac dysrhythmia?

Complete heart block

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?

Decreased cardiac output & decreased systolic and diastolic blood pressure

The nurse is assessing a patient with a probable diagnosis of first-degree AV block. The nurse is aware that this dysrhythmia is evident on an ECG strip by what indication?

Delayed conduction, producing a prolonged PR interval

Elective cardioversion is similar to defibrillation except that the electrical stimulation waits to discharge until an R wave appears. What does this prevent?

Disrupting the heart during the critical period of ventricular repolarization

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?

Document the findings and continue to monitor the client

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?

Double-check the monitoring equipment.

The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?

Fluttering

The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia? PR interval of 0.24 seconds. OR Heart rate of 42 beats per minute (bpm).

Heart rate of 42 beats per minute (bpm).

The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)?

Hypokalemia

Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?

Monitor vital signs and cardiac rhythm

To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform?

P wave

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:

inherent rhythmicity of cardiac muscle tissue.

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?

Right side of sternum, fourth intercostal space

An operating room nurse is caring for a client who is having a pacemaker implanted. The health care provider has requested a demand mode pacemaker for this client. What is this type of pacemaker?

Self-activated

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?

Sinus tachycardia

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

normal sinus rhythm.

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?

The registered nurse administering atropine sulfate intravenously

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?

Warfarin

The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include?

Your family and friends may want to take a CPR class.

The nurse is caring for a client with second-degree atrioventricular block, Type I with symptomatic bradycardia. What is the most likely medication the nurse will administer?

atropine sulfate

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

avoid caffeinated beverages.

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?

begin CPR

The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia?

hypovolemia

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