Dysrhythmias
Question 1: The nurse is caring for a client who had a
(see full question) permanent pacemaker surgically placed yesterday
and is now ready for discharge. Which statement
made by the client indicates the need for more
education.
Correct response: "We will be getting rid of our microwave oven so it
will not affect my pacemaker."
Explanation: Permanent pacemaker generators have filters that
protect them from electrical interference from
most household devices, motors, and appliances.
Question 2: A home care nurse is visiting a left-handed client
(see full question) who has an implantable cardioverter-defibrillator
(ICD) implanted in his left chest. The client tells
the nurse how excited he is because he's planning
to go rifle hunting with his grandson. How should
the nurse respond?
You selected: "You can't shoot a rifle left-handed because the
rifle's recoil will traumatize the ICD site."
Correct
Explanation: The recoil from the rifle can damage the ICD, so
the client should be warned against shooting a
rifle with his left hand. Close proximity to a rifle
won't cause the ICD to fire inadvertently. The
client shouldn't take an extra dose of his
antiarrhythmic. (less)
Question 3: A 73-year-old client has returned to the
(see full question) postanesthesia care unit where you practice
nursing. The client had a pacemaker implanted
and it is your responsibility to begin client
education upon his becoming alert. Which of the
following postimplantation instructions must you
provide to the client now that he has a permanent
pacemaker?
Correct response: Avoid sources of electrical interference.
Explanation: The nurse must instruct the client with a
, permanent pacemaker to avoid sources of
electrical interference, such as MRI devices, large
industrial motors, peripheral nerve stimulators,
etc. The main warning to a client with a
pacemaker is to avoid sources of electrical
interference. (less)
Question 4: Your client has just been diagnosed with a
(see full question) dysrhythmia. The client asks you to explain
normal sinus rhythm. What would you explain is
the characteristic of normal sinus rhythm?
You selected: The sinoatrial (SA) node initiates the impulse.
Correct
Explanation: The characteristics of normal sinus rhythm are
heart rate between 60 and 100 beats/minute, the
SA node initiates the impulse, the impulse travels
to the AV node in 0.12 to 0.2 second, the
ventricles depolarize in 0.12 seconds or less, and
each impulse occurs regularly. (less)
Question 5: A patient with hypertension has a newly
(see full question) diagnosed atrial fibrillation. What medication does
the nurse anticipate administering to prevent the
complication of atrial thrombi?
You selected: Warfarin (Coumadin)
Correct
Explanation: Because atrial function may be impaired for
several weeks after cardioversion, warfarin is
indicated for at least 4 weeks after the procedure.
Patients may be given amiodarone (Cordarone),
flecainide (Tambocor), ibutilide (Corvert),
propafenone (Rythmol), or sotalol (Betapace) prior
to cardioversion to enhance the success of
cardioversion and prevent relapse of the atrial
fibrillation (Fuster, Rydén et al., 2011). (less)
, Question 6: The nurse is attempting to determine the
(see full question) ventricular rate and rhythm of a patient’s telemetry
strip. What should the nurse examine to
determine this part of the analysis?
Correct response: RR interval
Explanation: The rhythm is often identified at the same time the
rate is determined. The RR interval is used to
determine ventricular rhythm and the PP interval
to determine atrial rhythm. If the intervals are the
same or if the difference between the intervals is
less than 0.8 seconds throughout the strip, the
rhythm is called regular. If the intervals are
different, the rhythm is called irregular. (less)
Question 7: The licensed practical nurse is monitoring the
(see full question) waveform pattern on the cardiac monitor ofthe
client admitted following a myocardial infarction.
The nurse notes that every other beat includes a
premature ventricular contraction (PVC). The
nurse notes which of the following in the
permanent record?
Correct response: Bigeminy
Explanation: The nurse is correct to note bigeminy on the
permanent record when every other beat is a
PVC. Couplets are two PVCs in a row. Multifocal
PVCs originate from more than one location. R-
on-T phenomenon occurs when the R wave falls
on the T wave. (less)
Question 8: The nurse is analyzing a 6-second
(see full question) electrocardiogram (ECG) tracing. The P waves
and QRS complexes are regular. The PR interval
is 0.18 seconds long, and the QRS complexes are
0.08 seconds long. The heart rate is calculated at
70 bpm. The nurse correctly identifies this rhythm
as which of the following?
You selected: Normal sinus rhythm
Correct
Question 1: The nurse is caring for a client who had a
(see full question) permanent pacemaker surgically placed yesterday
and is now ready for discharge. Which statement
made by the client indicates the need for more
education.
Correct response: "We will be getting rid of our microwave oven so it
will not affect my pacemaker."
Explanation: Permanent pacemaker generators have filters that
protect them from electrical interference from
most household devices, motors, and appliances.
Question 2: A home care nurse is visiting a left-handed client
(see full question) who has an implantable cardioverter-defibrillator
(ICD) implanted in his left chest. The client tells
the nurse how excited he is because he's planning
to go rifle hunting with his grandson. How should
the nurse respond?
You selected: "You can't shoot a rifle left-handed because the
rifle's recoil will traumatize the ICD site."
Correct
Explanation: The recoil from the rifle can damage the ICD, so
the client should be warned against shooting a
rifle with his left hand. Close proximity to a rifle
won't cause the ICD to fire inadvertently. The
client shouldn't take an extra dose of his
antiarrhythmic. (less)
Question 3: A 73-year-old client has returned to the
(see full question) postanesthesia care unit where you practice
nursing. The client had a pacemaker implanted
and it is your responsibility to begin client
education upon his becoming alert. Which of the
following postimplantation instructions must you
provide to the client now that he has a permanent
pacemaker?
Correct response: Avoid sources of electrical interference.
Explanation: The nurse must instruct the client with a
, permanent pacemaker to avoid sources of
electrical interference, such as MRI devices, large
industrial motors, peripheral nerve stimulators,
etc. The main warning to a client with a
pacemaker is to avoid sources of electrical
interference. (less)
Question 4: Your client has just been diagnosed with a
(see full question) dysrhythmia. The client asks you to explain
normal sinus rhythm. What would you explain is
the characteristic of normal sinus rhythm?
You selected: The sinoatrial (SA) node initiates the impulse.
Correct
Explanation: The characteristics of normal sinus rhythm are
heart rate between 60 and 100 beats/minute, the
SA node initiates the impulse, the impulse travels
to the AV node in 0.12 to 0.2 second, the
ventricles depolarize in 0.12 seconds or less, and
each impulse occurs regularly. (less)
Question 5: A patient with hypertension has a newly
(see full question) diagnosed atrial fibrillation. What medication does
the nurse anticipate administering to prevent the
complication of atrial thrombi?
You selected: Warfarin (Coumadin)
Correct
Explanation: Because atrial function may be impaired for
several weeks after cardioversion, warfarin is
indicated for at least 4 weeks after the procedure.
Patients may be given amiodarone (Cordarone),
flecainide (Tambocor), ibutilide (Corvert),
propafenone (Rythmol), or sotalol (Betapace) prior
to cardioversion to enhance the success of
cardioversion and prevent relapse of the atrial
fibrillation (Fuster, Rydén et al., 2011). (less)
, Question 6: The nurse is attempting to determine the
(see full question) ventricular rate and rhythm of a patient’s telemetry
strip. What should the nurse examine to
determine this part of the analysis?
Correct response: RR interval
Explanation: The rhythm is often identified at the same time the
rate is determined. The RR interval is used to
determine ventricular rhythm and the PP interval
to determine atrial rhythm. If the intervals are the
same or if the difference between the intervals is
less than 0.8 seconds throughout the strip, the
rhythm is called regular. If the intervals are
different, the rhythm is called irregular. (less)
Question 7: The licensed practical nurse is monitoring the
(see full question) waveform pattern on the cardiac monitor ofthe
client admitted following a myocardial infarction.
The nurse notes that every other beat includes a
premature ventricular contraction (PVC). The
nurse notes which of the following in the
permanent record?
Correct response: Bigeminy
Explanation: The nurse is correct to note bigeminy on the
permanent record when every other beat is a
PVC. Couplets are two PVCs in a row. Multifocal
PVCs originate from more than one location. R-
on-T phenomenon occurs when the R wave falls
on the T wave. (less)
Question 8: The nurse is analyzing a 6-second
(see full question) electrocardiogram (ECG) tracing. The P waves
and QRS complexes are regular. The PR interval
is 0.18 seconds long, and the QRS complexes are
0.08 seconds long. The heart rate is calculated at
70 bpm. The nurse correctly identifies this rhythm
as which of the following?
You selected: Normal sinus rhythm
Correct
