Chapter 29: Coordinating Care for Patients With Cardiac
Dysrhythmia
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A patient’s heart rate is 48 beats per minute. Which structure is most likely generating this
heart rate?
1) Purkinje fibers
2) Sinoatrial node
3) Atrioventricular node
4) Ventricular pacer cells
2. The nurse is concerned that a patient is at risk for pulseless electrical activity. What infor-
mation from the assessment did the nurse use to make this clinical decision?
1) Blood pH 7.30
2) Temperature 100.5°F
3) Serum glucose level 170 mg/dL
4) Serum potassium level 4.1 mEq/L
3. A patient asks why cardiac leads are being placed on the chest. What should the nurse re-
spond to this patient?
1) “It shows where the heart vessels
are blocked.”
2) “It is used to evaluate the effective-
ness of dietary changes.”
3) “It provides a graphic picture of
the heart’s electrical activity.”
4) “It determines which medications
are needed to improve heart func-
tion.”
4. When analyzing a patient’s electrocardiogram, the nurse notes that the P wave is normal.
What criteria did the nurse use to make this decision?
1) Pointed and skinny in width
2) Small and rounded in lead II
3) Upright and rounded in lead II
4) Length 0.10 seconds and height
2.5 mm
5. A patient is being evaluated for a blockage in the cardiac ventricles. On which part of the
electrocardiogram should the nurse focus as evidence of this blockage?
1) T wave
Page 1 of 25
, 2) U wave
3) PR interval
4) QRS interval
6. The nurse is observed marching out the rhythm on a patient’s cardiac monitor tracing.
What is this nurse assessing?
1) Rate
2) Polarity
3) Regularity
4) Amplitude
7. A patient with shortness of breath has a heart rhythm of 46 beats per minute. Which medi-
cation should the nurse anticipate being prescribed for this patient?
1) Atropine sulfate
2) Atenolol (Tenormin)
3) Diltiazem (Cardizem)
4) Adenosine (Adenocard)
8. A patient with atrial fibrillation has a heart rate of 90 beats per minute. Which manifesta-
tion should the nurse expect to assess in this patient?
1) Headache
2) Chest pain
3) Palpitations
4) Hypotension
9. A patient with atrial fibrillation is being considered for cardioversion. Which diagnostic test
should the nurse anticipate being prescribed prior to this procedure being completed?
1) Chest x-ray
2) CT scan of the chest
3) 12-lead electrocardiogram
4) Transesophageal echocardiogram
(TEE)
10. A patient is experiencing supraventricular tachycardia. What should be done before deter-
mining this patient’s treatment?
1) Assess for thyroid disease
2) Identify the underlying rhythm
3) Evaluate serum electrolyte values
4) Study lifestyle and behavioral habits
11. A patient is admitted for treatment for a low junctional rhythm. Where should the nurse
Page 2 of 25
, expect to assess the P wave on this patient’s electrocardiogram?
1) Prior to the QRS wave
2) Buried within the QRS wave
3) At the tail end of the QRS wave
4) Superimposed over the previous
T wave
12. A patient’s cardiac rhythm has no identifiable P or QRS waves. What action should the
nurse take first?
1) Apply oxygen
2) Assess a radial pulse
3) Insert an intravenous line
4) Begin chest compressions
13. A patient is in normal sinus rhythm with prolonged PR intervals. What treatment should
the nurse expect to be prescribed for this patient?
1) Continue to monitor
2) Anticipate defibrillating
3) Prepare for cardioversion
4) Prepare for pacemaker insertion
14. The nurse notes that PR intervals are getting progressively longer before a QRS complex
is dropped on a patient’s cardiac rhythm strip. Which health problem should the nurse
real- ize this patient is experiencing?
1) Mobitz I
2) Mobitz II
3) First-degree AV block
4) Third-degree AV block
15. A patient is being prepared for a transvenous pacemaker. What should the nurse include
when explaining this pacemaker to the family?
1) “It is inserted using an internal jugu-
lar vein.”
2) “It is done by placing
defibrillator pads on the torso
using an anterior/posterior
position.”
3) “It is done by placing a pacer wire in
the atrium or the ventricle and fed
out through the skin, where it is at-
tached to an external pacemaker.”
4) “It is inserted by placing pacer wires
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Dysrhythmia
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A patient’s heart rate is 48 beats per minute. Which structure is most likely generating this
heart rate?
1) Purkinje fibers
2) Sinoatrial node
3) Atrioventricular node
4) Ventricular pacer cells
2. The nurse is concerned that a patient is at risk for pulseless electrical activity. What infor-
mation from the assessment did the nurse use to make this clinical decision?
1) Blood pH 7.30
2) Temperature 100.5°F
3) Serum glucose level 170 mg/dL
4) Serum potassium level 4.1 mEq/L
3. A patient asks why cardiac leads are being placed on the chest. What should the nurse re-
spond to this patient?
1) “It shows where the heart vessels
are blocked.”
2) “It is used to evaluate the effective-
ness of dietary changes.”
3) “It provides a graphic picture of
the heart’s electrical activity.”
4) “It determines which medications
are needed to improve heart func-
tion.”
4. When analyzing a patient’s electrocardiogram, the nurse notes that the P wave is normal.
What criteria did the nurse use to make this decision?
1) Pointed and skinny in width
2) Small and rounded in lead II
3) Upright and rounded in lead II
4) Length 0.10 seconds and height
2.5 mm
5. A patient is being evaluated for a blockage in the cardiac ventricles. On which part of the
electrocardiogram should the nurse focus as evidence of this blockage?
1) T wave
Page 1 of 25
, 2) U wave
3) PR interval
4) QRS interval
6. The nurse is observed marching out the rhythm on a patient’s cardiac monitor tracing.
What is this nurse assessing?
1) Rate
2) Polarity
3) Regularity
4) Amplitude
7. A patient with shortness of breath has a heart rhythm of 46 beats per minute. Which medi-
cation should the nurse anticipate being prescribed for this patient?
1) Atropine sulfate
2) Atenolol (Tenormin)
3) Diltiazem (Cardizem)
4) Adenosine (Adenocard)
8. A patient with atrial fibrillation has a heart rate of 90 beats per minute. Which manifesta-
tion should the nurse expect to assess in this patient?
1) Headache
2) Chest pain
3) Palpitations
4) Hypotension
9. A patient with atrial fibrillation is being considered for cardioversion. Which diagnostic test
should the nurse anticipate being prescribed prior to this procedure being completed?
1) Chest x-ray
2) CT scan of the chest
3) 12-lead electrocardiogram
4) Transesophageal echocardiogram
(TEE)
10. A patient is experiencing supraventricular tachycardia. What should be done before deter-
mining this patient’s treatment?
1) Assess for thyroid disease
2) Identify the underlying rhythm
3) Evaluate serum electrolyte values
4) Study lifestyle and behavioral habits
11. A patient is admitted for treatment for a low junctional rhythm. Where should the nurse
Page 2 of 25
, expect to assess the P wave on this patient’s electrocardiogram?
1) Prior to the QRS wave
2) Buried within the QRS wave
3) At the tail end of the QRS wave
4) Superimposed over the previous
T wave
12. A patient’s cardiac rhythm has no identifiable P or QRS waves. What action should the
nurse take first?
1) Apply oxygen
2) Assess a radial pulse
3) Insert an intravenous line
4) Begin chest compressions
13. A patient is in normal sinus rhythm with prolonged PR intervals. What treatment should
the nurse expect to be prescribed for this patient?
1) Continue to monitor
2) Anticipate defibrillating
3) Prepare for cardioversion
4) Prepare for pacemaker insertion
14. The nurse notes that PR intervals are getting progressively longer before a QRS complex
is dropped on a patient’s cardiac rhythm strip. Which health problem should the nurse
real- ize this patient is experiencing?
1) Mobitz I
2) Mobitz II
3) First-degree AV block
4) Third-degree AV block
15. A patient is being prepared for a transvenous pacemaker. What should the nurse include
when explaining this pacemaker to the family?
1) “It is inserted using an internal jugu-
lar vein.”
2) “It is done by placing
defibrillator pads on the torso
using an anterior/posterior
position.”
3) “It is done by placing a pacer wire in
the atrium or the ventricle and fed
out through the skin, where it is at-
tached to an external pacemaker.”
4) “It is inserted by placing pacer wires
Page 3 of 25
