Dysrhythmias Practice Questions
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1. You are the nurse working on Answer: D
the telemetry unit and you
have finally gotten to sit down A pulse would be assessed for first. Then
to work on some charting. the patient will be defibrillized and chest
Suddenly the heart monitors compressions will begin immediately.
at the station start beeping.
Patient in room 18 is show-
ing this rhythm on the monitor.
The medical team advances
together into the room and
finds them unconscious. What
is priority action by the nurse?
A) Prepare to administer
adenosine to the patient
B) Begin chest compressions
C) Prepare for defibrillation
D) Check for a pulse
2. The patient who has recent- Answer: A
ly been experiencing runs of
ventricular tachycardia sud- Following defibrillation, CPR is immediately
denly loses consciousness. initiated if a perfusable rhythm is not initi-
The patient is defibrillated, and ated. The client may need to be shocked
the rate returns as the follow- again, but chest compressions must begin
ing. What should the nurse do first.
first?
A) Begin compressions
B) Shock the client again im-
mediately
C) Prepare for intubation
D) Administer adenosine
3. The patient with a history Answer: B
of hypertension and diabetes
has the following rhythm strip. Atrial flutter places the client at high risk for
The patient's vitals are as fol- development of clot formation in the atria.
lows: BP 145/89, HR 90, SpO2 Because the client is stable at this time,
95%, RR 19. Which of the fol- cardioversion or adenosine would not be
lowing does the nurse expect performed at this time. Before cardioversion
, Dysrhythmias Practice Questions
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to do at this time? can occur in a patient, anticoagulant therapy
a) Prepare the client for car- should be begun at least 48 hours before-
dioversion STAT hand if possible.
b) Begin administering antico-
agulants
c) Grab the crash cart for ad-
ministration of adenosine
d) Teach the client about pos-
sibility of pacemaker installa-
tion
4. The nurse is preparing to ad- Answer: A, B, and D
minister adenosine to the pa-
tient with the following rhythm Adenosine is administered as a very quick
which is symptomatic. What IV push. The physician must be present in
should the nurse plan on hav- the room and the crash cart must be on
ing in the patient room? Select hand. An ekg monitor should be in the room
All That Apply: to monitor the effectiveness of the medica-
a) Physician tion.
b) Crash cart
c) IV pump
d) EKG monitor
e) Lidocaine
5. The nurse has just adminis- Answer: B
tered adenosine via IV push
and sees the following rhythm This finding would be expected upon admin-
on the monitor. What is the istration of adenosine. The rhythm should
nurse's priority intervention? then begin again in some other rhythm,
a) Apply conductive gel and hopefully normal sinus rhythm. It would be
defibrillate the patient important to document the exact time of this
b) Document the findings and change and continue to monitor the change
continue to monitor back to NSR. If this change does not occur,
c) Administer another mg of or if another rhythm is produced, appropri-
the medication ate action would then be taken based on the
d) Begin chest compressions result.
, Dysrhythmias Practice Questions
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6. A group of nursing students Answer(s): 2, 3
are discussing atrial flutter.
These students recognize that The ATRIAL rate is 250-400 bpm. Ventricu-
which of the following are lar is about 75-150. The rhythm is regular,
seen with atrial flutter? Select with the P wave appearing as little flutter or
all that apply: a "saw tooth pattern". The PR interval is not
1) Ventricular rate of 220-300 measurable r/t this saw-tooth P wave. The
bpm. QRS is normal.
2) Regular rhythm
3) Saw-tooth pattern
4) Measurable PR interval
5) Long QRS interval
7. A nursing student is aware Answer: 2
that which of the following is
the treatment for unstable atri- Cardioversion is used if the patient is unsta-
al flutter? ble. Anticoagulants are used if the arrhyth-
1) Adenosine (Adenocard) 6 mia has stuck around for 48 hr +. Adenosine
mg rapid IVP. may be used with a narrow QRS and regular
2) Cardioversion with adjacent RR interval
Heparin therapy
3) Defibrillation STAT followed
by CPR.
4) Altemose 3 mg IVP over 1-2
seconds.
8. A nurse working on a CVT unit Answer: 2
receives report from day shift.
After receiving report, which Patients with a-fib are at risk for pulmonary
patient should the nurse see and systemic emboli, and new onset of con-
first? fusion may indicate a stroke in this patient.
1) A 23-year-old professional Patients with atrial flutter may feel more tired
tennis player with a HR of 47 some days than others.
bpm.
2) A 69-year-old male with atri-
al fibrillation who has new on-
set confusion.
3) A 72-year-old female with
atrial flutter who reports feel-
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