STUVIA 2024/2025
Nclex Style EKG Practice
A. Normal Sinus Rhythm
measurements are normal, measuring 0.12 to 0.20 second and 0.4 to 0.10 second, respectively. -
✔✔A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart
rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal Sinus Rhythm
B. Sinus Bradycardia
C. Sick Sinus Syndrome
D. First-degree heart block
B. Tightly Secured Cable Connections
Motion artifact, or "noise," can be caused by frequent client movement, electrode placement on limbs,
and insufficient adhesion to the skin, such as placing electrodes over hairy areas of the skin.
Electrode placement over bony prominences also should be avoided. Signal interference can also
occur with electrode removal and cable disconnection. - ✔✔A nurse notices frequent artifact on the
ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse
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examines the client to determine the cause. Which of the following items is unlikely to be responsible
for the artifact?
A.Frequent movement of the client
B. Tightly secured cable connections
C. Leads applied over hairy areas
D. Leads applied to the limbs
B. Ventricular Tachycardia
Ventricular tachycardia is characterized by the absence of P waves, wide QRS complexes (usually
greater than 0.14 second), and a rate between 100 and 250 impulses per minute. The rhythm is
usually regular. - ✔✔A nurse is watching the cardiac monitor and notices that the rhythm suddenly
changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but
over 100. The nurse determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Sinus tachycardia
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, STUVIA 2024/2025
C. Administer amiodarone (Cordarone) intravenously
First-line treatment of ventricular tachycardia in a client who is hemodynamically stable is the use of
anti-dysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide
(Pronestyl). Cardioversion also may be needed to correct the rhythm (cardioversion is recommended
for stable ventricular tachycardia). Defibrillation is used with pulseless ventricular tachycardia.
Epinephrine would stimulate and already excitable ventricle and is contraindicated - ✔✔A nurse is
viewing the cardiac monitor in a client's room and notes that the client has just gone into ventricular
tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do
which of the following?
A. Immediately defibrillate
B. Prepare for pacemaker insertion
C. Administer amiodarone (Cordarone) intravenously
D. Administer epinephrine (Adrenaline) intravenously
B. Inhale deeply and cough forcefully every 1 to 3 seconds.
Cough cardiopulmonary resuscitation (CPR) sometimes is used in the client with unstable ventricular
tachycardia. The nurse tells the client to use cough CPR, if prescribed, by inhaling deeply and
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coughing forcefully every 1 to 3 seconds. Cough CPR may terminate the dysrhythmia or sustain the
cerebral and coronary circulation for a short time until other measures can be implemented - ✔✔A
nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do
which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily
B. Inhale deeply and cough forcefully every 1 to 3 seconds
C. Lie down flat in bed
D. Remove any metal jewelry
A.
Premature ventricular contractions can cause hemodynamic compromise. The shortened ventricular
filling time with the ectopic beats leads to decreased stroke volume and, if frequent enough, to
decreased cardiac output. The client may be asymptomatic or may feel palpitations. PVCs can be
caused by cardiac disorders or by any number of physiological stressors, such as infection, illness,
surgery, or trauma, and by the intake of caffeine, alcohol, or nicotine. - ✔✔A client is having frequent
premature ventricular contractions. A nurse would place priority on assessment of which of the
following items?
A. Blood pressure and peripheral perfusion
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