Dysrhythmias Practice Questions with Correct Answers |100% Verified|
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Course
DYSRHYTHMIA
Institution
DYSRHYTHMIA
Dysrhythmias Practice Questions with
Correct Answers |100% Verified|
A 26-year-old client with atrial fibrillation that has not responded to medication therapy has arrived at
the hospital for an elective cardioversion. Which of the following patient statements most concerns the
nurse?
1) ...
Dysrhythmias Practice Questions with
Correct Answers |100% Verified|
A 26-year-old client with atrial fibrillation that has not responded to medication therapy has arrived at
the hospital for an elective cardioversion. Which of the following patient statements most concerns the
nurse?
1) "I can't wait to stop taking this Coumadin. I've been on this crap for weeks now."
2) "I'm starving. I haven't eaten anything in 3 hours."
3) "I feel really short of breath, can I lie down?"
4) "I haven't taken my Digoxin since 9 o'clock last night. Is that okay?" *Ans*✨Answer: 3
Patients with atrial fibrillation are at incredibly high risk for clots, even with anticoagulation therapy.
Shortness of breath could indicate a PE, and this should be immediately investigated by the nurse. The
patient should be NPO for at least 4 hr. prior to the procedure related to anesthesia use, but this is not
as urgent of a concern. The patient should also withhold Digoxin therapy for 48 hours to ensure that,
once cardioverted, NSR returns.
A client admitted after using crack cocaine develops ventricular fibrillation. After determining
unresponsiveness, which action should the nurse take next?
a. Defibrillate at 200
b. Establish IV access.
c. Place an oral airway and ventilate.
d. Start cardiopulmonary resuscitation (CPR). *Ans*✨Answer: A
Rationale: Defibrillating is of priority before any other resuscitative measures according to Advanced
Cardiac Life Support protocols.
A client with atrial fibrillation with rapid ventricular response has received medication to slow the
ventricular rate. The pulse is now 88. For which additional therapy does the nurse plan?
a. Synchronized cardioversion
b. Electrophysiology studies (EPS)
,c. Anticoagulation
d. Radiofrequency ablation therapy *Ans*✨Answer: C
Rationale: Because of the risk for thromboembolism, anticoagulation is necessary.
A group of nursing students are discussing atrial flutter. These students recognize that which of the
following are seen with atrial flutter? Select all that apply:
1) Ventricular rate of 220-300 bpm.
2) Regular rhythm
3) Saw-tooth pattern
4) Measurable PR interval
5) Long QRS interval *Ans*✨Answer(s): 2, 3
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P wave
appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nurse on a CVT unit views the monitor and sees the patient in room 452 has just begun having
occasional PVCs. Which action should the nurse take first?
1) Check on the patient
2) Check last magnesium and potassium levels
3) Document the occurrence and watch for further PVCs
4) Contact the physician *Ans*✨Answer: 1
Although electrolytes are likely the culprit, the nurse first needs to first assess the patient. Then, the
nurse should look in the patient's chart and evaluate or request an order for electrolyte levels. This may
eventually need to be documented, but the nurse can be held liable for neglect if he/she does not assess
the patient first. The physician may or may not need to be contacted.
A nurse working on a CVT unit receives report from day shift. After receiving report, which patient
should the nurse see first?
, 1) A 23-year-old professional tennis player with a HR of 47 bpm.
2) A 69-year-old male with atrial fibrillation who has new onset confusion.
3) A 72-year-old female with atrial flutter who reports feeling unusually tired today and yesterday.
4) A 33-year-old female with sinus tachycardia who is asking for her at-home Metoprolol.
*Ans*✨Answer: 2
Patients with a-fib are at risk for pulmonary and systemic emboli, and new onset of confusion may
indicate a stroke in this patient. Patients with atrial flutter may feel more tired some days than others.
A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
1) Adenosine (Adenocard) 6 mg rapid IVP.
2) Cardioversion with adjacent Heparin therapy
3) Defibrillation STAT followed by CPR.
4) Altemose 3 mg IVP over 1-2 seconds. *Ans*✨Answer: 2
Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has stuck
around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval
A patient in asystole is likely to receive which of the following drug treatments?
a. Atropine and epinephrine
b. Lidocaine and amiodarone
c. Digoxin and procainamide
d. β-Adrenergic blockers and dopamine *Ans*✨Answer: A
Rationale: Normally the patient in asystole cannot be successfully resuscitated. However, administration
of atropine and epinephrine may prompt the return of depolarization and ventricular contraction.
For which of the following dysrhythmias is defibrillation primarily indicated?
a. Ventricular fibrillation
b. Third-degree AV block
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