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CHAA STUDY GUIDE QUESTIONS WITH CORRECT ANSWERS.
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CHAA STUDY GUIDE QUESTIONS WITH CORRECT ANSWERS.
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CHAA STUDY GUIDE QUESTIONS WITHCORRECT ANSWERS
1. A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS
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complexes are regular. The PR interval is 0.16 second, and QRS complexes measure
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0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the
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cardiac rhythm as:
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A. Normal sinus rhythm
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B. Sinus bradycardia
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C. Sick sinus syndrome
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D. First-degree heart block. - Correct Answer - 1. measurements are normal, measuring
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0.12 to 0.20 second and 0.4 to 0.10 second, respectively.
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2 A nurse notices frequent artifact on the ECG monitor for a client whose leads are
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connected by cable to a console at the bedside. The nurse examines the client to
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determine the cause. Which of the following items is unlikely to be responsible for the
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artifact?
b
1. Frequent movement of the client
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2. Tightly secured cable connections
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3. Leads applied over hairy areas
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4. Leads applied to the limbs - Correct Answer - 2. Motion artifact, or "noise," can be
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caused by frequent client movement, electrode placement on limbs, and insufficient
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adhesion to the skin, such as placing electrodes over hairy areas of the skin. Electrode
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placement over bony prominences also should be avoided. Signal interference can also
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occur with electrode removal and cable disconnection.
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3. A nurse is watching the cardiac monitor and notices that the rhythm suddenly
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changes. There are no P waves, the QRS complexes are wide, and the ventricular rate
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is regular but over 100. The nurse determines that the client is experiencing:
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1. Premature ventricular contractions
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2. Ventricular tachycardia
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3. Ventricular fibrillation
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4. Sinus tachycardia - Correct Answer - 2. Ventricular tachycardia is characterized by
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the absence of P waves, wide QRS complexes (usually greater than 0.14 second), and
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a rate between 100 and 250 impulses per minute. The rhythm is usually regular.
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4. A nurse is viewing the cardiac monitor in a client's room and notes that the client has
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just gone into ventricular tachycardia. The client is awake and alert and has good skin
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color. The nurse would prepare to do which of the following?
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1. Immediately defibrillate
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2. Prepare for pacemaker insertion
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3. Administer amiodarone (Cordarone) intravenously
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, 4. Administer epinephrine (Adrenaline) intravenously - Correct Answer - 3. First-line
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treatment of ventricular tachycardia in a client who is hemodynamically stable is the use
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of anti-dysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and
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procainamide (Pronestyl). Cardioversion also may be needed to correct the rhythm
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(cardioversion is recommended for stable ventricular tachycardia). Defibrillation is used
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with pulseless ventricular tachycardia. Epinephrine would stimulate and already
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excitable ventricle and is contraindicated.
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5. A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs
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the client to do which of the following, if prescribed, during an episode of ventricular
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tachycardia?
b
1. Breathe deeply, regularly, and easily.
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2. Inhale deeply and cough forcefully every 1 to 3 seconds.
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3. Lie down flat in bed
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4. Remove any metal jewelry - Correct Answer - 2. Cough cardiopulmonary
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resuscitation (CPR) sometimes is used in the client with unstable ventricular
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tachycardia. The nurse tells the client to use cough CPR, if prescribed, by inhaling
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deeply and coughing forcefully every 1 to 3 seconds. Cough CPR may terminate the
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dysrhythmia or sustain the cerebral and coronary circulation for a short time until other
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measures can be implemented.
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6. A client is having frequent premature ventricular contractions. A nurse would place
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priority on assessment of which of the following items?
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1. Blood pressure and peripheral perfusion
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2. Sensation of palpitations
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3. Causative factors such as caffeine
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4. Precipitating factors such as infection - Correct Answer - 1. Premature ventricular
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contractions can cause hemodynamic compromise. The shortened ventricular filling
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time with the ectopic beats leads to decreased stroke volume and, if frequent enough,
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to decreased cardiac output. The client may be asymptomatic or may feel palpations.
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PVCs can be caused by cardiac disorders or by any number of physiological stressors,
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such as infection, illness, surgery, or trauma, and by the intake of caffeine, alcohol, or
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nicotine.
b
7. A client has developed atrial fibrillation, which a ventricular rate of 150 beats per
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minute. A nurse assesses the client for:
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1. Hypotension and dizziness
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2. Nausea and vomiting
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3. Hypertension and headache
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4. Flat neck veins - Correct Answer - 1. The client with uncontrolled atrial fibrillation with
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a ventricular rate more than 150 beats a minute is at risk for low cardiac output
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because of loss of atrial kick. The nurse assesses the client for palpitations, chest pain
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or discomfort, hypotension, pulse deficit, fatigue, weakness, dizziness, syncope,
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shortness of breath, and distended neck veins.
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