Dysrhythmias Questions With Correct Answers 2022
To determine whether there is a delay in impulse conduction through the ventricles,
the nurse will measure the duration of the patient's
a. P wave. c. PR interval.
b. Q wave. d. QRS complex. - ANS: D
The QRS complex represents ventricular depolarization. The P wave represents the
depolarization of the atria. The PR interval represents depolarization of the atria,
atrioventricular node, bundle of His, bundle branches, and the Purkinje fibers. The Q
wave is the first negative deflection following the P wave and should be narrow and
short.
The nurse needs to quickly estimate the heart rate for a patient with a regular heart
rhythm. Which method will be best to use?
a. Count the number of large squares in the R-R interval and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
c. Use the 3-second markers to count the number of QRS complexes in 6 seconds
and multiply by 10.
d. Calculate the number of small squares between one QRS complex and the next
and divide into 1500. - ANS: C
This is the quickest way to determine the ventricular rate for a patient with a regular
rhythm. All the other methods are accurate, but take longer.
A patient has a junctional escape rhythm on the monitor. The nurse will expect the
patient to have a heart rate of _____ beats/min.
a. 15 to 20 c. 40 to 60
b. 20 to 40 d. 60 to 100 - ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will
automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates
are typical of the bundle of His and Purkinje system and may be seen with failure of
both the SA and AV node to discharge. The normal SA node rate is 60 to 100
beats/min.
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction
and makes the following analysis: no visible P waves, PR interval not measurable,
ventricular rate of 162, R-R interval regular, and QRS complex wide and distorted,
and QRS duration of 0.18 second. The nurse interprets the patient's cardiac rhythm
as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia. - ANS: D
The absence of P waves, wide QRS, rate greater than 150 beats/min, and the
regularity of the rhythm indicate ventricular tachycardia. Atrial flutter is usually
regular, has a narrow QRS configuration, and has flutter waves present representing
atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular and
does not have a consistent QRS duration.
The nurse notes that a patient's heart monitor shows that every other beat is earlier
than expected, has no visible P wave, and has a QRS complex that is wide and
bizarre in shape. How will the nurse document the rhythm?
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, a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions - ANS: B
Ventricular bigeminy describes a rhythm in which every other QRS complex is wide
and bizarre looking. Pairs of wide QRS complexes are described as ventricular
couplets. There is no indication that the premature ventricular contractions are
multifocal or that the R-on-T phenomenon is occurring.
A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse determines
that the PR interval is 0.24 seconds. The most appropriate intervention by the nurse
would be to
a. notify the health care provider immediately.
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
d. prepare the patient for temporary pacemaker insertion. - ANS: B
First-degree atrioventricular block is asymptomatic and requires ongoing monitoring
because it may progress to more serious forms of heart block. The rate is normal, so
there is no indication that atropine is needed. Immediate notification of the health
care provider about an asymptomatic rhythm is not necessary.
A patient who was admitted with a myocardial infarction experiences a 45-second
episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of
98 beats/min. Which action should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Prepare to give IV amiodarone per agency dysrhythmia protocol.
d. Perform synchronized cardioversion per agency dysrhythmia protocol. - ANS: C
The burst of sustained ventricular tachycardia indicates that the patient has
significant ventricular irritability, and antidysrhythmic medication administration is
needed to prevent further episodes. The nurse should notify the health care provider
after the medication is started. Cardioversion is not indicated given that the patient
has returned to a sinus rhythm. Documentation and continued monitoring are not
adequate responses to this situation.
After the nurse gives IV atropine to a patient with symptomatic type 1, second-
degree atrioventricular (AV) block, which finding indicates that the drug has been
effective?
a. Increase in the patient's heart rate
b. Increase in strength of peripheral pulses
c. Decrease in premature atrial contractions
d. Decrease in premature ventricular contractions - ANS: A
Atropine will increase the heart rate and conduction through the AV node. Because
the drug increases electrical conduction, not cardiac contractility, the quality of the
peripheral pulses is not used to evaluate the drug effectiveness. The patient does
not have premature atrial or ventricular contractions.
A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been
unresponsive to drug therapy for several days. Teaching for this patient would
include information about
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To determine whether there is a delay in impulse conduction through the ventricles,
the nurse will measure the duration of the patient's
a. P wave. c. PR interval.
b. Q wave. d. QRS complex. - ANS: D
The QRS complex represents ventricular depolarization. The P wave represents the
depolarization of the atria. The PR interval represents depolarization of the atria,
atrioventricular node, bundle of His, bundle branches, and the Purkinje fibers. The Q
wave is the first negative deflection following the P wave and should be narrow and
short.
The nurse needs to quickly estimate the heart rate for a patient with a regular heart
rhythm. Which method will be best to use?
a. Count the number of large squares in the R-R interval and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
c. Use the 3-second markers to count the number of QRS complexes in 6 seconds
and multiply by 10.
d. Calculate the number of small squares between one QRS complex and the next
and divide into 1500. - ANS: C
This is the quickest way to determine the ventricular rate for a patient with a regular
rhythm. All the other methods are accurate, but take longer.
A patient has a junctional escape rhythm on the monitor. The nurse will expect the
patient to have a heart rate of _____ beats/min.
a. 15 to 20 c. 40 to 60
b. 20 to 40 d. 60 to 100 - ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will
automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates
are typical of the bundle of His and Purkinje system and may be seen with failure of
both the SA and AV node to discharge. The normal SA node rate is 60 to 100
beats/min.
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction
and makes the following analysis: no visible P waves, PR interval not measurable,
ventricular rate of 162, R-R interval regular, and QRS complex wide and distorted,
and QRS duration of 0.18 second. The nurse interprets the patient's cardiac rhythm
as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia. - ANS: D
The absence of P waves, wide QRS, rate greater than 150 beats/min, and the
regularity of the rhythm indicate ventricular tachycardia. Atrial flutter is usually
regular, has a narrow QRS configuration, and has flutter waves present representing
atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular and
does not have a consistent QRS duration.
The nurse notes that a patient's heart monitor shows that every other beat is earlier
than expected, has no visible P wave, and has a QRS complex that is wide and
bizarre in shape. How will the nurse document the rhythm?
dr.j
, a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions - ANS: B
Ventricular bigeminy describes a rhythm in which every other QRS complex is wide
and bizarre looking. Pairs of wide QRS complexes are described as ventricular
couplets. There is no indication that the premature ventricular contractions are
multifocal or that the R-on-T phenomenon is occurring.
A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse determines
that the PR interval is 0.24 seconds. The most appropriate intervention by the nurse
would be to
a. notify the health care provider immediately.
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
d. prepare the patient for temporary pacemaker insertion. - ANS: B
First-degree atrioventricular block is asymptomatic and requires ongoing monitoring
because it may progress to more serious forms of heart block. The rate is normal, so
there is no indication that atropine is needed. Immediate notification of the health
care provider about an asymptomatic rhythm is not necessary.
A patient who was admitted with a myocardial infarction experiences a 45-second
episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of
98 beats/min. Which action should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Prepare to give IV amiodarone per agency dysrhythmia protocol.
d. Perform synchronized cardioversion per agency dysrhythmia protocol. - ANS: C
The burst of sustained ventricular tachycardia indicates that the patient has
significant ventricular irritability, and antidysrhythmic medication administration is
needed to prevent further episodes. The nurse should notify the health care provider
after the medication is started. Cardioversion is not indicated given that the patient
has returned to a sinus rhythm. Documentation and continued monitoring are not
adequate responses to this situation.
After the nurse gives IV atropine to a patient with symptomatic type 1, second-
degree atrioventricular (AV) block, which finding indicates that the drug has been
effective?
a. Increase in the patient's heart rate
b. Increase in strength of peripheral pulses
c. Decrease in premature atrial contractions
d. Decrease in premature ventricular contractions - ANS: A
Atropine will increase the heart rate and conduction through the AV node. Because
the drug increases electrical conduction, not cardiac contractility, the quality of the
peripheral pulses is not used to evaluate the drug effectiveness. The patient does
not have premature atrial or ventricular contractions.
A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been
unresponsive to drug therapy for several days. Teaching for this patient would
include information about
dr.j
