EXAM STUDY MATERIALS July 23, 2024 4:26 PM Wk 3: Chapter 4 Dysrhythmias (book) Exam Questions With Verified Answers
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Course
Dysrhythmias
Institution
Dysrhythmias
Wk 3: Chapter 4 Dysrhythmias (book) Exam
Questions With Verified Answers
Correct Answer: 2
Rationale 1: Epinephrine is not indicated for unstable bradycardia.
Rationale 2: Because this patient is complaining of shortness of breath and mild chest
discomfort, he is considered to be unstable. For...
EXAM STUDY MATERIALS July 23, 2024 4:26 PM Wk 3: Chapter 4 Dysrhythmias (book) Exam Questions With Verified Answers Correct Answer: 2 Rationale 1: Epinephrine is not indicated for unstable bradycardia. Rationale 2: Beca use this patient is complaining of shortness of breath and mild chest discomfort, he is considered to be unstable. For the unstable patient, the treatment of choice for this rhythm (second -degree type I block) is atropine 0.5 to 1 mg IV. Rationale 3: Aden osine is the treatment for SVT and slows the heart rate down. Rationale 4: Amiodarone is the treatment for ventricular irritability as seen with ventricular fibrillation and pulseless ventricular tachycardia. - answer✔✔A 57 -year-old male patient is admitt ed to the telemetry unit with new onset of weakness and fatigue. The following rhythm is now seen on the monitor and the patient is now complaining of shortness of breath and mild chest discomfort. Which medication would be appropriate for this patient? Second Degree Type I Block 1. Give epinephrine 1 mg IV. 2. Give atropine 0.5 mg IV. 3. Give adenosine 6 mg IV. 4. Give amiodarone 300 mg IV. Correct Answer: 4 Rationale 1: A short period of asystole followed by conversion to NSR is usually seen with treatment of SVT with adenosine. Rationale 2: This finding indicates adequate tissue perfusion and would not be present in a patient with unstable bradycardia. Rationale 3: This assessment finding would not be present in an unstable patient in third -degree AVB. EXAM STUDY MATERIALS July 23, 2024 4:26 PM Rationale 4: A heart rate of 42 and a BP of 78/60 are not adequate and indicate that the patient is unstable with third -degree heart block. - answer✔✔A 78 -year-old patient has the following rhythm. Which assessment finding identifies a need for further treatment? Third Degree AV block 1. Short period of asystole followed by conversion to normal sinus rhythm 2. Warm, dry skin 3. Heart rate of 88 and BP 124/80 4. Heart rate of 42 and BP 78/60 Correct Answer: 1 Rationale 1: This patient is in atrial fibrillation. From the information given, it sounds as if he has a history of atrial fibrillation. It would be correct to perform a 12 -lead ECG and compare it to previous tracings. Rationale 2: This is a stable patie nt at this time and does not need transcutaneous pacing. Rationale 3: This is a stable patient at this time and does not need 100% O2. Rationale 4: The patient does not seem to be anxious. Therefore, Versed is not indicated at this time. - answer✔✔A 67 -year-old male patient complaining of "feeling tired" has the following cardiac rhythm. The patient states that he has a history of an irregular heartbeat. His vital signs are BP 134/78; RR 17; SaO2 97% on room air. He denies other complaints at present. The priority action for this patient would be to: Atrial Fibrillation 1. Perform a 12 -lead ECG and compare it to previously recorded ECGs. 2. Prepare the patient for transcutaneous pacing. 3. Place the patient on 100% via nonrebreather mask. 4. Give Versed 1 mg IVP. Correct Answer: 4 Rationale 1: Defibrillation is not indicated in asystole. EXAM STUDY MATERIALS July 23, 2024 4:26 PM Rationale 2: Even though atropine is indicated in the asystole protocol, it is not given first and is not repeated every 3 minutes because there is a maximum dose limit. Rationale 3: Amiodarone is indicated for ventricular dysrhythmias. Rationale 4: Epinephrine should be given first for the treatment of asystole in addition to CPR. - answer✔✔CPR is started on a patient who has developed ventricular fibrillation. The patie nt is defibrillated once with the resulting rhythm. Which intervention should the nurse implement next? Asystole 1. Defibrillate the patient with 360 joules. 2. Administer atropine 1 mg IV push and repeat every 3 minutes. 3. Infuse amiodarone 300 mg IV push slowly. 4. Administer epinephrine 1 mg IV push. Correct Answer: 3 Rationale 1: Oxygen is indicated for shortness of breath. Rationale 2: Morphine is administered for chest pain. Rationale 3: Atropine would be questioned because atropine is the drug of choice for unstable bradycardia, not ventricular irritability. Rationale 4: Amiodarone is the drug of choice to decrease ventricular irritability and multifocal PVCs. - answer✔✔A pa tient arrives in the emergency department for chest pain, lightheadedness, and shortness of breath (SOB). The cardiac monitor shows sinus rhythm with the presence of multifocal PVCs. Which order would the nurse question? 1. Oxygen at 4 L/min via nasal can nula 2. Morphine sulfate 2 mg IV 3. Atropine 0.5 mg IV 4. Amiodarone 300 mg IV Correct Answer: 2 Rationale 1: A precordial thump should not be done.
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