Exam 1: Dysrhythmias (NCLEX) Exam Questions With Verified Answers
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Course
Dysrhythmias
Institution
Dysrhythmias
EXAM STUDY MATERIALS July 23, 2024 4:26 PM
Exam 1: Dysrhythmias (NCLEX) Exam
Questions With Verified Answers
A client's electrocardiogram strip shows atrial and ventricular rates of 80 complexes per minute.
The PR interval is 0.14 second, and the QRS complex measures 0.08 second. The nurse
int...
EXAM STUDY MATERIALS July 23, 2024 4:26 PM Exam 1: Dysrhythmias (NCLEX) Exam Questions With Verified Answers A client's electrocardiogram strip shows atrial and ventricular rates of 80 complexes per minute. The PR interval is 0.14 second, and the QRS complex measures 0.08 second. The nurse interprets this rhythm is: A) Normal sinus rhythm B) Sinus bradycardia C) Sinus tachycardia D) Sinus dysrhythmia - answer✔✔A A client has frequent bursts of ventricular tachycardia on the cardiac monitor. A nurse is most concerned with this dysrhythmia because: A) It is uncomfortable for the client, giving a sense of impending doom. B) It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia. C) It is almost impossible to convert to a normal sinus rhythm. D) It can develop into ventricular fibrillation at any time. - answer✔✔D Ventricular tachyca rdia is a life -threatening dysrhythmia that results from an irritable ectopic focus that takes over as the pacemaker for the heart. The low cardiac output that results can lead quickly to cerebral and myocardial ischemia. Client's frequently experience a f eeling of impending death. Ventricular tachycardia is treated with antidysrhythmic medications or magnesium sulfate, cardioversion (client awake), or defibrillation (loss of consciousness), Ventricular tachycardia can deteriorate into ventricular defibrill ation at any time. The nurse administers amiodarone (Cordarone) to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? Select all that apply. a. Respiratory rate b. QT interval EXAM STUDY MATERIALS July 23, 2024 4:26 PM c. Heart rate and rhythm d. Magn esium level e. Urine output - answer✔✔BCD Amiodarone causes prolongation of the QT interval, which can precipitate dysrhythmia. Antidysrhythmic medications cause changes in cardiac rhythm and rate; therefore monitoring of heart rate and rhythm is needed.El ectrolyte depletion, specifically potassium and magnesium, may predispose to further dysrhythmia. Although it is always important to monitor vital signs and urine output, these assessments are not specific to amiodarone. The nurse is caring for a client wi th acute coronary syndrome (ACS) and atrial fibrillation who has a new prescription for metoprolol (Lopressor). Which monitoring is essential when administering the medication? a. ST segment b. Heart rate c. Troponin d. Myoglobin - answer✔✔B The effects of metoprolol are to decrease heart rate, blood pressure, and myocardial oxygen demand. ST segment elevation is consistent with MI; it does not address monitoring of metoprolol. Elevation in troponin is consistent with a diagnosis of MI but doe s not address needed monitoring for metoprolol. Elevation in myoglobin is consistent with myocardial injury in ACS but does not address needed monitoring related to metoprolol. The nurse is caring for a client with atrial fibrillation. In addition to an an tidysrhythmic, what medication does the nurse plan to administer? a. Heparin b. Atropine c. Dobutamine d. Magnesium sulfate - answer✔✔A Clients with atrial fibrillation are prone to blood pooling in the atrium, clotting, then embolizing. Heparin is used t o prevent thrombus development in the atrium and the consequence of embolization (i.e., stroke). The nurse is caring for a client on a telemetry unit with a regular heart rhythm and rate of 60; a P wave precedes each QRS complex, and the PR interval is 0.2 4 second. Additional vital signs are EXAM STUDY MATERIALS July 23, 2024 4:26 PM as follows: blood pressure 118/68, respiratory rate 16, and temperature 98.8° F. The following medications are available on the medication record. What action should the nurse take? a. Administer atropine. b. Administe r digoxin. c. Administer clonidine. d. Continue to monitor. - answer✔✔D The client is displaying sinus rhythm with first -degree atrioventicular heart block; this is usually asymptomatic and does not require treatment. Atropine is used in emergency treatmen t of symptomatic bradycardia. This client has normal vital signs. Digoxin is used in the treatment of atrial fibrillation, which is, by definition, an irregular rhythm. Clonidine is used in the treatment of hypertension; a side effect is bradycardia. You a re the charge nurse on the telemetry unit and are responsible for making client assignments. Which client would be appropriate to assign to the float RN from the medical -
surgical unit? a. The 64 -year-old admitted for weakness who has a first -degree heart block with a heart rate of 58 beats/min b. The 71 -year-old admitted for heart failure who is short of breath and has a heart rate of 120 to 130 beats/min c. The 88 -year-old admitted with an elevated troponin level who is hypotensive with a heart rate of 96 beats/min d. The 92 -year-old admitted with chest pain who has premature ventricular complexes and a heart rate of 102 beats/min - answer✔✔A This client has a stable, asymptomatic dysrhythmia, which usually requires no treatment; this client can be managed by a nurse with less cardiac dysrhythmia training. A client with atrial fibrillation with rapid ventricular response has received medication to slow the ventricular rate. The pulse is now 88. For which additional therapy does the nurse plan? a. Synchroni zed cardioversion b. Electrophysiology studies (EPS) c. Anticoagulation
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