Inquire through: | Professional | Confidential Support
Chapter 31: Concepts of Care for Patients
With Dysrhythmias Ignatavicius: Medical-
Surgical Nursing, 10th Edition Verified and
Updated Questions and Answers (100%
Correct Answers)
1. A nurse assesses a client's electrocardiograph tracing and observes that not all
QRS complexes are preceded by a P wave. How would the nurse interpret this
observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client's chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites
Answer: ANS: D
Normal rhythm shows one P wave preceding each QRS complex, indicating that all
depolarization is initiated at the sinoatrial node. QRS complexes without a P wave
indicate a different source of initiation of depolarization. This finding on an
electrocardiograph tracing is not an indication of hyperkalemia, ventricular
tachycardia, or disconnection of leads.
2. A nurse cares for a client who has a heart rate averaging 56 beats/min with no
adverse symptoms. Which activity modification would the nurse suggest to avoid
further slowing of the heart rate?
a. "Make certain that your bath water is warm."
b. "Avoid straining while having a bowel movement."
c. "Limit your intake of caffeinated drinks to one a day."
d. "Avoid strenuous exercise such as running."
Answer: ANS: B
, Inquire through: | Professional | Confidential Support
Bearing down strenuously during a bowel movement is one type of Valsalva
maneuver, which stimulates the vagus nerve and results in slowing of the heart rate.
Such a response is not desirable in a person who has bradycardia. The other
instructions are not appropriate for this condition.
3. A nurse is assessing clients on a medical-surgical unit. Which client would the
nurse identify as being at greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily.
b. A 50-year-old who is post coronary artery bypass graft surgery.
c. A 78-year-old who had a carotid endarterectomy.
d. An 80-year-old with chronic obstructive pulmonary disease.
Answer: ANS: B
Atrial fibrillation occurs commonly in clients with cardiac disease. Other risk factors
include hypertension (HTN), previous ischemic stroke, transient ischemic attack (TIA)
or other thromboembolic event, diabetes mellitus, heart failure, obesity,
hyperthyroidism, chronic kidney disease, excessive alcohol use, and mitral valve
disease. The other conditions do not place these clients at higher risk for atrial
fibrillation.
4. A nurse assesses a client with atrial fibrillation. Which manifestation would alert
the nurse to the possibility of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
Answer: ANS: B
Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic
events includes changes in mentation, speech, sensory function, and motor function.
Clients with atrial fibrillation often have a rapid ventricular response as a result.
Fatigue is a nonspecific complaint. Clients with atrial fibrillation often have dyspnea
as a result of the decreased cardiac output caused by the rhythm disturbance
Chapter 31: Concepts of Care for Patients
With Dysrhythmias Ignatavicius: Medical-
Surgical Nursing, 10th Edition Verified and
Updated Questions and Answers (100%
Correct Answers)
1. A nurse assesses a client's electrocardiograph tracing and observes that not all
QRS complexes are preceded by a P wave. How would the nurse interpret this
observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client's chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites
Answer: ANS: D
Normal rhythm shows one P wave preceding each QRS complex, indicating that all
depolarization is initiated at the sinoatrial node. QRS complexes without a P wave
indicate a different source of initiation of depolarization. This finding on an
electrocardiograph tracing is not an indication of hyperkalemia, ventricular
tachycardia, or disconnection of leads.
2. A nurse cares for a client who has a heart rate averaging 56 beats/min with no
adverse symptoms. Which activity modification would the nurse suggest to avoid
further slowing of the heart rate?
a. "Make certain that your bath water is warm."
b. "Avoid straining while having a bowel movement."
c. "Limit your intake of caffeinated drinks to one a day."
d. "Avoid strenuous exercise such as running."
Answer: ANS: B
, Inquire through: | Professional | Confidential Support
Bearing down strenuously during a bowel movement is one type of Valsalva
maneuver, which stimulates the vagus nerve and results in slowing of the heart rate.
Such a response is not desirable in a person who has bradycardia. The other
instructions are not appropriate for this condition.
3. A nurse is assessing clients on a medical-surgical unit. Which client would the
nurse identify as being at greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily.
b. A 50-year-old who is post coronary artery bypass graft surgery.
c. A 78-year-old who had a carotid endarterectomy.
d. An 80-year-old with chronic obstructive pulmonary disease.
Answer: ANS: B
Atrial fibrillation occurs commonly in clients with cardiac disease. Other risk factors
include hypertension (HTN), previous ischemic stroke, transient ischemic attack (TIA)
or other thromboembolic event, diabetes mellitus, heart failure, obesity,
hyperthyroidism, chronic kidney disease, excessive alcohol use, and mitral valve
disease. The other conditions do not place these clients at higher risk for atrial
fibrillation.
4. A nurse assesses a client with atrial fibrillation. Which manifestation would alert
the nurse to the possibility of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
Answer: ANS: B
Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic
events includes changes in mentation, speech, sensory function, and motor function.
Clients with atrial fibrillation often have a rapid ventricular response as a result.
Fatigue is a nonspecific complaint. Clients with atrial fibrillation often have dyspnea
as a result of the decreased cardiac output caused by the rhythm disturbance
