DYSRHYTHMIAS PRACTICE
QUESTIONS WITH CORRECT
QUESTIONS AND ANSWERS
You4are4the4nurse4working4on4the4telemetry4unit4and4you4have4finally4gotten4to4
sit4down4to4work4on4some4charting.4Suddenly4the4heart4monitors4at4the4station4s
tart4beeping.4Patient4in4room4184is4showing4this4rhythm4on4the4monitor.4The4me
dical4team4advances4together4into4the4room4and4finds4them4unconscious.4What4i
s4priority4action4by4the4nurse?
A)4Prepare4to4administer4adenosine4to4the4patient
B)4Begin4chest4compressions
C)4Prepare4for4defibrillation
D)4Check4for4a4pulse4-4answer-Answer:4D
A4pulse4would4be4assessed4for4first.4Then4the4patient4will4be4defibrillized4and4ch
est4compressions4will4begin4immediately.
The4patient4who4has4recently4been4experiencing4runs4of4ventricular4tachycardia4s
uddenly4loses4consciousness.4The4patient4is4defibrillated,4and4the4rate4returns4as
4the4following.4What4should4the4nurse4do4first?
A)4Begin4compressions
B)4Shock4the4client4again4immediately
C)4Prepare4for4intubation
D)4Administer4adenosine4-4answer-Answer:4A
Following4defibrillation,4CPR4is4immediately4initiated4if4a4perfusable4rhythm4is4not
4initiated.4The4client4may4need4to4be4shocked4again,4but4chest4compressions4mu
st4begin4first.
The4patient4with4a4history4of4hypertension4and4diabetes4has4the4following4rhythm
4strip.4The4patient's4vitals4are4as4follows:4BP4145/89,4HR490,4SpO2495%,4RR419
.4Which4of4the4following4does4the4nurse4expect4to4do4at4this4time?
a)4Prepare4the4client4for4cardioversion4STAT
b)4Begin4administering4anticoagulants
c)4Grab4the4crash4cart4for4administration4of4adenosine
d)4Teach4the4client4about4possibility4of4pacemaker4installation4-4answer-
Answer:4B
Atrial4flutter4places4the4client4at4high4risk4for4development4of4clot4formation4in4th
e4atria.4Because4the4client4is4stable4at4this4time,4cardioversion4or4adenosine4wou
,ld4not4be4performed4at4this4time.4Before4cardioversion4can4occur4in4a4patient,4an
ticoagulant4therapy4should4be4begun4at4least4484hours4beforehand4if4possible.
The4nurse4is4preparing4to4administer4adenosine4to4the4patient4with4the4following4
rhythm4which4is4symptomatic.4What4should4the4nurse4plan4on4having4in4the4patie
nt4room?4Select4All4That4Apply:4
a)4Physician
b)4Crash4cart
c)4IV4pump
d)4EKG4monitor
e)4Lidocaine4-4answer-Answer:4A,4B,4and4D
Adenosine4is4administered4as4a4very4quick4IV4push.4The4physician4must4be4pres
ent4in4the4room4and4the4crash4cart4must4be4on4hand.4An4ekg4monitor4should4b
e4in4the4room4to4monitor4the4effectiveness4of4the4medication.
The4nurse4has4just4administered4adenosine4via4IV4push4and4sees4the4following4r
hythm4on4the4monitor.4What4is4the4nurse's4priority4intervention?
a)4Apply4conductive4gel4and4defibrillate4the4patient
b)4Document4the4findings4and4continue4to4monitor
c)4Administer4another4mg4of4the4medication
d)4Begin4chest4compressions4-4answer-Answer:4B
This4finding4would4be4expected4upon4administration4of4adenosine.4The4rhythm4sh
ould4then4begin4again4in4some4other4rhythm,4hopefully4normal4sinus4rhythm.4It4w
ould4be4important4to4document4the4exact4time4of4this4change4and4continue4to4m
onitor4the4change4back4to4NSR.4If4this4change4does4not4occur,4or4if4another4rhyt
hm4is4produced,4appropriate4action4would4then4be4taken4based4on4the4result.
A4group4of4nursing4students4are4discussing4atrial4flutter.4These4students4recogniz
e4that4which4of4the4following4are4seen4with4atrial4flutter?4Select4all4that4apply:
1)4Ventricular4rate4of4220-3004bpm.
2)4Regular4rhythm
3)4Saw-tooth4pattern
4)4Measurable4PR4interval4
5)4Long4QRS4interval4-4answer-Answer(s):42,43
The4ATRIAL4rate4is4250-4004bpm.4Ventricular4is4about475-
150.4The4rhythm4is4regular,4with4the4P4wave4appearing4as4little4flutter4or4a4"saw
4tooth4pattern".4The4PR4interval4is4not4measurable4r/t4this4saw-
tooth4P4wave.4The4QRS4is4normal.
A4nursing4student4is4aware4that4which4of4the4following4is4the4treatment4for4unsta
ble4atrial4flutter?
1)4Adenosine4(Adenocard)464mg4rapid4IVP.
2)4Cardioversion4with4adjacent4Heparin4therapy
, 3)4Defibrillation4STAT4followed4by4CPR.
4)4Altemose434mg4IVP4over41-24seconds.4-4answer-Answer:42
Cardioversion4is4used4if4the4patient4is4unstable.4Anticoagulants4are4used4if4the4ar
rhythmia4has4stuck4around4for4484hr4+.4Adenosine4may4be4used4with4a4narrow4
QRS4and4regular4RR4interval
A4nurse4working4on4a4CVT4unit4receives4report4from4day4shift.4After4receiving4re
port,4which4patient4should4the4nurse4see4first?
1)4A423-year-old4professional4tennis4player4with4a4HR4of4474bpm.
2)4A469-year-old4male4with4atrial4fibrillation4who4has4new4onset4confusion.
3)4A472-year-
old4female4with4atrial4flutter4who4reports4feeling4unusually4tired4today4and4yesterd
ay.
4)4A433-year-old4female4with4sinus4tachycardia4who4is4asking4for4her4at-
home4Metoprolol.4-4answer-Answer:42
Patients4with4a-
fib4are4at4risk4for4pulmonary4and4systemic4emboli,4and4new4onset4of4confusion4
may4indicate4a4stroke4in4this4patient.4Patients4with4atrial4flutter4may4feel4more4tir
ed4some4days4than4others.
A4nurse4on4a4CVT4unit4views4the4monitor4and4sees4the4patient4in4room44524ha
s4just4begun4having4occasional4PVCs.4Which4action4should4the4nurse4take4first?
1)4Check4on4the4patient
2)4Check4last4magnesium4and4potassium4levels
3)4Document4the4occurrence4and4watch4for4further4PVCs
4)4Contact4the4physician4-4answer-Answer:41
Although4electrolytes4are4likely4the4culprit,4the4nurse4first4needs4to4first4assess4th
e4patient.4Then,4the4nurse4should4look4in4the4patient's4chart4and4evaluate4or4req
uest4an4order4for4electrolyte4levels.4This4may4eventually4need4to4be4documented,
4but4the4nurse4can4be4held4liable4for4neglect4if4he/
she4does4not4assess4the4patient4first.4The4physician4may4or4may4not4need4to4b
e4contacted.
Which4of4the4following4does4the4nursing4student4realize4is4the4treatment4for4a4st
able4patient4presenting4with4QRS4intervals4above40.124seconds4with4a4regular4rh
ythm4and4a4rate4of4100-2504bpm?
1)4Atropine
2)4Defibrillation
3)4Amiodarone
4)4Adenosine4-4answer-Answer:43
QUESTIONS WITH CORRECT
QUESTIONS AND ANSWERS
You4are4the4nurse4working4on4the4telemetry4unit4and4you4have4finally4gotten4to4
sit4down4to4work4on4some4charting.4Suddenly4the4heart4monitors4at4the4station4s
tart4beeping.4Patient4in4room4184is4showing4this4rhythm4on4the4monitor.4The4me
dical4team4advances4together4into4the4room4and4finds4them4unconscious.4What4i
s4priority4action4by4the4nurse?
A)4Prepare4to4administer4adenosine4to4the4patient
B)4Begin4chest4compressions
C)4Prepare4for4defibrillation
D)4Check4for4a4pulse4-4answer-Answer:4D
A4pulse4would4be4assessed4for4first.4Then4the4patient4will4be4defibrillized4and4ch
est4compressions4will4begin4immediately.
The4patient4who4has4recently4been4experiencing4runs4of4ventricular4tachycardia4s
uddenly4loses4consciousness.4The4patient4is4defibrillated,4and4the4rate4returns4as
4the4following.4What4should4the4nurse4do4first?
A)4Begin4compressions
B)4Shock4the4client4again4immediately
C)4Prepare4for4intubation
D)4Administer4adenosine4-4answer-Answer:4A
Following4defibrillation,4CPR4is4immediately4initiated4if4a4perfusable4rhythm4is4not
4initiated.4The4client4may4need4to4be4shocked4again,4but4chest4compressions4mu
st4begin4first.
The4patient4with4a4history4of4hypertension4and4diabetes4has4the4following4rhythm
4strip.4The4patient's4vitals4are4as4follows:4BP4145/89,4HR490,4SpO2495%,4RR419
.4Which4of4the4following4does4the4nurse4expect4to4do4at4this4time?
a)4Prepare4the4client4for4cardioversion4STAT
b)4Begin4administering4anticoagulants
c)4Grab4the4crash4cart4for4administration4of4adenosine
d)4Teach4the4client4about4possibility4of4pacemaker4installation4-4answer-
Answer:4B
Atrial4flutter4places4the4client4at4high4risk4for4development4of4clot4formation4in4th
e4atria.4Because4the4client4is4stable4at4this4time,4cardioversion4or4adenosine4wou
,ld4not4be4performed4at4this4time.4Before4cardioversion4can4occur4in4a4patient,4an
ticoagulant4therapy4should4be4begun4at4least4484hours4beforehand4if4possible.
The4nurse4is4preparing4to4administer4adenosine4to4the4patient4with4the4following4
rhythm4which4is4symptomatic.4What4should4the4nurse4plan4on4having4in4the4patie
nt4room?4Select4All4That4Apply:4
a)4Physician
b)4Crash4cart
c)4IV4pump
d)4EKG4monitor
e)4Lidocaine4-4answer-Answer:4A,4B,4and4D
Adenosine4is4administered4as4a4very4quick4IV4push.4The4physician4must4be4pres
ent4in4the4room4and4the4crash4cart4must4be4on4hand.4An4ekg4monitor4should4b
e4in4the4room4to4monitor4the4effectiveness4of4the4medication.
The4nurse4has4just4administered4adenosine4via4IV4push4and4sees4the4following4r
hythm4on4the4monitor.4What4is4the4nurse's4priority4intervention?
a)4Apply4conductive4gel4and4defibrillate4the4patient
b)4Document4the4findings4and4continue4to4monitor
c)4Administer4another4mg4of4the4medication
d)4Begin4chest4compressions4-4answer-Answer:4B
This4finding4would4be4expected4upon4administration4of4adenosine.4The4rhythm4sh
ould4then4begin4again4in4some4other4rhythm,4hopefully4normal4sinus4rhythm.4It4w
ould4be4important4to4document4the4exact4time4of4this4change4and4continue4to4m
onitor4the4change4back4to4NSR.4If4this4change4does4not4occur,4or4if4another4rhyt
hm4is4produced,4appropriate4action4would4then4be4taken4based4on4the4result.
A4group4of4nursing4students4are4discussing4atrial4flutter.4These4students4recogniz
e4that4which4of4the4following4are4seen4with4atrial4flutter?4Select4all4that4apply:
1)4Ventricular4rate4of4220-3004bpm.
2)4Regular4rhythm
3)4Saw-tooth4pattern
4)4Measurable4PR4interval4
5)4Long4QRS4interval4-4answer-Answer(s):42,43
The4ATRIAL4rate4is4250-4004bpm.4Ventricular4is4about475-
150.4The4rhythm4is4regular,4with4the4P4wave4appearing4as4little4flutter4or4a4"saw
4tooth4pattern".4The4PR4interval4is4not4measurable4r/t4this4saw-
tooth4P4wave.4The4QRS4is4normal.
A4nursing4student4is4aware4that4which4of4the4following4is4the4treatment4for4unsta
ble4atrial4flutter?
1)4Adenosine4(Adenocard)464mg4rapid4IVP.
2)4Cardioversion4with4adjacent4Heparin4therapy
, 3)4Defibrillation4STAT4followed4by4CPR.
4)4Altemose434mg4IVP4over41-24seconds.4-4answer-Answer:42
Cardioversion4is4used4if4the4patient4is4unstable.4Anticoagulants4are4used4if4the4ar
rhythmia4has4stuck4around4for4484hr4+.4Adenosine4may4be4used4with4a4narrow4
QRS4and4regular4RR4interval
A4nurse4working4on4a4CVT4unit4receives4report4from4day4shift.4After4receiving4re
port,4which4patient4should4the4nurse4see4first?
1)4A423-year-old4professional4tennis4player4with4a4HR4of4474bpm.
2)4A469-year-old4male4with4atrial4fibrillation4who4has4new4onset4confusion.
3)4A472-year-
old4female4with4atrial4flutter4who4reports4feeling4unusually4tired4today4and4yesterd
ay.
4)4A433-year-old4female4with4sinus4tachycardia4who4is4asking4for4her4at-
home4Metoprolol.4-4answer-Answer:42
Patients4with4a-
fib4are4at4risk4for4pulmonary4and4systemic4emboli,4and4new4onset4of4confusion4
may4indicate4a4stroke4in4this4patient.4Patients4with4atrial4flutter4may4feel4more4tir
ed4some4days4than4others.
A4nurse4on4a4CVT4unit4views4the4monitor4and4sees4the4patient4in4room44524ha
s4just4begun4having4occasional4PVCs.4Which4action4should4the4nurse4take4first?
1)4Check4on4the4patient
2)4Check4last4magnesium4and4potassium4levels
3)4Document4the4occurrence4and4watch4for4further4PVCs
4)4Contact4the4physician4-4answer-Answer:41
Although4electrolytes4are4likely4the4culprit,4the4nurse4first4needs4to4first4assess4th
e4patient.4Then,4the4nurse4should4look4in4the4patient's4chart4and4evaluate4or4req
uest4an4order4for4electrolyte4levels.4This4may4eventually4need4to4be4documented,
4but4the4nurse4can4be4held4liable4for4neglect4if4he/
she4does4not4assess4the4patient4first.4The4physician4may4or4may4not4need4to4b
e4contacted.
Which4of4the4following4does4the4nursing4student4realize4is4the4treatment4for4a4st
able4patient4presenting4with4QRS4intervals4above40.124seconds4with4a4regular4rh
ythm4and4a4rate4of4100-2504bpm?
1)4Atropine
2)4Defibrillation
3)4Amiodarone
4)4Adenosine4-4answer-Answer:43
