Relias Dysrhythmia- advanced A Questions
With Complete Solutions
Course
NURS 4572
1. Identify the following rhythm:
A patient presents with a heart rate of 180 bpm, narrow QRS complexes, and no visible P waves.
The rhythm is regular.
A) Sinus Tachycardia
B) Atrial Fibrillation
C) Supraventricular Tachycardia (SVT)
D) Ventricular Tachycardia
Answer: C) Supraventricular Tachycardia (SVT)
Rationale:
SVT is characterized by a rapid, regular rhythm, usually between 150-250 bpm, with a narrow
QRS complex and hidden or absent P waves due to their merging with the T waves. Sinus
tachycardia would show visible P waves, atrial fibrillation is irregular, and ventricular
tachycardia has a wide QRS complex.
2. Which of the following is the correct first-line treatment for stable SVT?
A) Synchronized cardioversion
B) Atropine 1 mg IV push
C) Vagal maneuvers followed by adenosine
D) Amiodarone 150 mg IV over 10 minutes
Answer: C) Vagal maneuvers followed by adenosine
Rationale:
For stable SVT, vagal maneuvers (e.g., bearing down, carotid massage) should be attempted
first. If unsuccessful, adenosine (6 mg rapid IV push) is the next step. Synchronized
cardioversion is reserved for unstable patients. Atropine is used for bradycardia, and amiodarone
is for ventricular arrhythmias.
3. Identify the following rhythm strip:
, A rhythm shows an irregularly irregular pattern, no distinct P waves, and a ventricular rate of
130 bpm.
A) Sinus Tachycardia
B) Atrial Fibrillation with Rapid Ventricular Response
C) Multifocal Atrial Tachycardia
D) Atrial Flutter
Answer: B) Atrial Fibrillation with Rapid Ventricular Response
Rationale:
Atrial fibrillation is irregularly irregular with no distinct P waves. Atrial flutter has a
"sawtooth" pattern. Multifocal atrial tachycardia has 3+ different P wave morphologies, and
sinus tachycardia is regular.
4. What is the priority intervention for a patient in unstable atrial fibrillation
with hypotension?
A) Administer beta-blockers
B) Perform synchronized cardioversion
C) Give amiodarone IV
D) Monitor the patient and reassess
Answer: B) Perform synchronized cardioversion
Rationale:
Unstable atrial fibrillation (hypotension, chest pain, altered mental status) requires
synchronized cardioversion to restore sinus rhythm. Beta-blockers and amiodarone are for
stable patients. Monitoring alone is insufficient for instability.
5. Which rhythm is most commonly associated with sudden cardiac arrest?
A) Atrial Flutter
B) Ventricular Fibrillation
C) Sinus Bradycardia
D) First-Degree AV Block
Answer: B) Ventricular Fibrillation
Rationale:
Ventricular fibrillation (VFib) is a chaotic, disorganized rhythm that leads to sudden cardiac
With Complete Solutions
Course
NURS 4572
1. Identify the following rhythm:
A patient presents with a heart rate of 180 bpm, narrow QRS complexes, and no visible P waves.
The rhythm is regular.
A) Sinus Tachycardia
B) Atrial Fibrillation
C) Supraventricular Tachycardia (SVT)
D) Ventricular Tachycardia
Answer: C) Supraventricular Tachycardia (SVT)
Rationale:
SVT is characterized by a rapid, regular rhythm, usually between 150-250 bpm, with a narrow
QRS complex and hidden or absent P waves due to their merging with the T waves. Sinus
tachycardia would show visible P waves, atrial fibrillation is irregular, and ventricular
tachycardia has a wide QRS complex.
2. Which of the following is the correct first-line treatment for stable SVT?
A) Synchronized cardioversion
B) Atropine 1 mg IV push
C) Vagal maneuvers followed by adenosine
D) Amiodarone 150 mg IV over 10 minutes
Answer: C) Vagal maneuvers followed by adenosine
Rationale:
For stable SVT, vagal maneuvers (e.g., bearing down, carotid massage) should be attempted
first. If unsuccessful, adenosine (6 mg rapid IV push) is the next step. Synchronized
cardioversion is reserved for unstable patients. Atropine is used for bradycardia, and amiodarone
is for ventricular arrhythmias.
3. Identify the following rhythm strip:
, A rhythm shows an irregularly irregular pattern, no distinct P waves, and a ventricular rate of
130 bpm.
A) Sinus Tachycardia
B) Atrial Fibrillation with Rapid Ventricular Response
C) Multifocal Atrial Tachycardia
D) Atrial Flutter
Answer: B) Atrial Fibrillation with Rapid Ventricular Response
Rationale:
Atrial fibrillation is irregularly irregular with no distinct P waves. Atrial flutter has a
"sawtooth" pattern. Multifocal atrial tachycardia has 3+ different P wave morphologies, and
sinus tachycardia is regular.
4. What is the priority intervention for a patient in unstable atrial fibrillation
with hypotension?
A) Administer beta-blockers
B) Perform synchronized cardioversion
C) Give amiodarone IV
D) Monitor the patient and reassess
Answer: B) Perform synchronized cardioversion
Rationale:
Unstable atrial fibrillation (hypotension, chest pain, altered mental status) requires
synchronized cardioversion to restore sinus rhythm. Beta-blockers and amiodarone are for
stable patients. Monitoring alone is insufficient for instability.
5. Which rhythm is most commonly associated with sudden cardiac arrest?
A) Atrial Flutter
B) Ventricular Fibrillation
C) Sinus Bradycardia
D) First-Degree AV Block
Answer: B) Ventricular Fibrillation
Rationale:
Ventricular fibrillation (VFib) is a chaotic, disorganized rhythm that leads to sudden cardiac
