Nurse 220 Unit 8 Cardiac dysthymias Exam Questions With Verified Answers
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Course
Dysrhythmias
Institution
Dysrhythmias
Nurse 220 Unit 8 Cardiac dysthymias Exam
Questions With Verified Answers
To determine whether there is a delay in impulse conduction through the atria, the nurse will
measure the length of the patient's
A.)P wave.
B.)PR interval.
C.)QT interval.
D.)QRS complex. - answerA.)
The P wave repres...
EXAM STUDY MATERIALS July 23, 2024 4:26 PM Nurse 220 Unit 8 Cardiac dysthymias Exam Questions With Verified Answers To deter mine whether there is a delay in impulse conduction through the atria, the nurse will measure the length of the patient's A.)P wave. B.)PR interval. C.)QT interval. D.)QRS complex. - answer✔✔A.) The P wave represents the depolarization of the atria. The P -R interval represents depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers. The QRS represents ventricular depolarization. The Q -T interval represents depolarization and repolarization of the enti re conduction system. A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a heart rate of how many beats/minute? A.)15 to 20 B.)20 to 40 C.)40 to 60 D.)60 to 100 - answer✔✔Answer: c. 40 to 60 Rationale: If the sinoatrial (SA) node does not discharge, the atrioventricular (AV) node will automatically discharge at the normal rate of 40 to 60 beats/min. The slower rates are typical of the bundle of His and Purkinje system and may be seen with fail ure of both the SA and AV node to discharge. The normal SA node rate is 60 to 100 beats/min. Which information will the nurse include when teaching a patient who is scheduled to have a permanent pacemaker inserted for treatment of chronic atrial fibrillati on with slow ventricular response? A.)The pacemaker prevents or minimizes ventricular irritability. B.)The pacemaker paces the atria at rates up to 500 impulses/minute. C.)The pacemaker discharges if ventricular fibrillation and cardiac arrest occur. EXAM STUDY MATERIALS July 23, 2024 4:26 PM D.)Th e pacemaker stimulates a heart beat if the patient's heart rate drops too low. - answer✔✔D.) The permanent pacemaker will discharge when the ventricular rate drops below the set rate. The pacemaker will not decrease ventricular irritability or discharge if the patient develops ventricular fibrillation. Since the patient has a slow ventricular rate, overdrive pacing will not be used. Which action by a new nurse who is caring for a patient who has just had an implantable cardioverter -defibrillator (ICD) inser ted indicates a need for more education about care of patients with ICDs? A.)The nurse assists the patient to do active range of motion exercises for all extremities. B.)The nurse assists the patient to fill out the application for obtaining a Medic Alert ID and bracelet. C.)The nurse gives atenolol (Tenormin) to the patient without consulting first with the health care provider. D.)The nurse teaches the patient that sexual activity usually can be resumed once the surgical incision is healed. - answer✔✔A.) The patient should avoid moving the arm on the ICD insertion site until healing has occurred to prevent displacement of the ICD leads. The other actions by the new nurse are appropriate for this patient. A patient has ST segment changes that indicate an ac ute inferior wall myocardial infarction. Which lead will be best for monitoring the patient? A.)I B.)II C.)V6 D.)MCL1 - answer✔✔Answer: b. II Rationale: Leads II, III, and AVF reflect the inferior area of the heart and the ST segment changes. Lead II will best capture any electrocardiographic changes that indicate further damage to the myocardium. The other leads do not reflect the inferior part of the myocardial wall and will not provide data about further ischemic changes in that area. A patient who is co mplaining of a "racing" heart and nervousness comes to the emergency department. The nurse places the patient on a cardiac monitor and obtains the following electrocardiographic (ECG) tracing. Which action should the nurse take next? (Sinus Tachycardia) A.)Get ready to perform electrical cardioversion. EXAM STUDY MATERIALS July 23, 2024 4:26 PM B.)Have the patient perform the Valsalva maneuver. C.)Obtain the patient's blood pressure and oxygen saturation. D.)Prepare to give b -blocker medication to slow the heart rate. - answer✔✔C.) The patient has sinus tachycardia, which may have multiple etiologies such as pain, dehydration, anxiety, and myocardial ischemia; further assessment is needed before determining the treatment. Vagal stimulation or b -blockade may be used after further assessment of the pa tient. Electrical cardioversion is used for some tachydysrhythmias, but would not be used for sinus tachycardia. The nurse admits a patient with a dysrhythmia. The nurse is aware that careful monitoring for asystole is necessary if the patient receives which medication? A.)Digoxin (Lanoxin) B.)Metoprolol (Lopressor) C.)Atropine D.)Adenosine (Adenocard) - answer✔✔D.) Adenosine (Adenocard)IV adenosine (Adenocard) is the first drug of choice to convert supraventricular tachycardia to a normal sinus rhythm. Adenosine is administered IV rapidly (over 1 or 2 seconds) followed by a rapid, normal saline flush. The nurse shoul d monitor the patient's ECG continuously because a brief period of asystole after adenosine administration is common and expected. Atropine sulfate increases heart rate, whereas lanoxin and metoprolol slow the heart rate. The nurse is monitoring a patient' s cardiac rhythm. Which rhythm would require the nurse to take immediate action? A.)Sinus tachycardia with a rate of 110 beats/minute B.)Atrial fibrillation with 6 to 8 QRS complexes per 6 second strip C.)Premature ventricular contractions (PVCs) at a rate of 12 per minute D.)First -degree AV block with a heart rate of 56 beats/minute - answer✔✔C.) Frequent premature ventricular contractions (PVCs) (greater than 1 every 10 beats) may reduce the cardiac output and precipitate angina and heart failure, dependi ng on their frequency. Because PVCs in CAD or acute MI indicate ventricular irritability, the patient's physiologic response to PVCs must be monitored. Frequent PVCs most likely must be treated with oxygen therapy, electrolyte replacement, or antidysrhythm ic agents. The nurse performs discharge teaching for a patient with an implantable cardioverter -
defibrillator. Which statement by the patient indicates to the nurse that further teaching is needed?
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